Facility Evaluation Report
Licensing Program Analyst (LPA) Steve Chang conducted an unannounced Case Management for a Non-Compliance Plan Visit and met with Administrator (ADM) Edward Tan.
LPA observed 4 residents and 4 staff in the facility.
The purpose of the visit is to ensure the facility is adhering to the Compliance Plan submitted to Community Care Licensing (CCL) after an Noncompliance Conference meeting held on 9/19/2024.
LPA toured the facility with staff ADM including resident rooms and backyard. LPA reviewed the LIC 500 with ADM. LPA confirmed with ADM that the facility has staff cover 24 hours 7 days. ADM stated S1 is the backup Administrator when ADM is not in the facility. ADM showed S1's administrator certificate.
LPA reviewed residents' physician reports, and appraisal needs and service plans with backup Administrator S1. LPA reviewed residents' medications and centrally stored medication forms with ADM. The reviewed documents are up to date.
The case management of inspections will be conducted every 3 months for 2 years.
No citation noted today. Exit interview was conducted with ADM. The report was provided to ADM for review and signature. A copy of the report was provided to ADM.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction