Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Case Management to conduct a Non-Compliance Plan Quarterly Visit and met with Administrator (ADM) Tammy Lu. The purpose of the visit is to ensure the facility is adhering to the Compliance Plan submitted to Community Care Licensing (CCL) after an informal meeting held on 06/21/2022. LPA Rai observed 1 staff member and 2 residents at the facilty since 4 residents were attending adult day program.

LPA reviewed 3 resident files, staff training files and facility file. LPA observed 3 out of 3 resident files had updated Appraisals/ Needs and Services Plan. LPA observed staff training completed for staff adhering to resident's behavioral and intervention plan, ensuring resident's personal rights are not violated, emergency intervention/ prohibited use of manual restrains on residents in care and reporting incident reports in a timely manner to the Department.

LPA Rai reviewed facility's intake process, facility's training plan on topics such as adhering to behavioral plan & resident's rights, and facility's process for complying with reporting incidents to the Department in a timely manner.

LPA Rai also concluded the two (2) year quarterly inspection visits which was initiated after a Non-Compliance Conference held on 06/21/2022 concludes this quarter. LPA advised staff to ensure that care and supervision is afforded to residents, and to stay in compliance with Title 22 regulations and in conjunction to their program policy.

No deficiencies cited per California Code of Regulations, Title 22. This report was reviewed with Administrator (ADM) Tammy Lu and a copy of the report was provided.