Facility Evaluation Report

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced case management visit. LPA announced the purpose of the visit and met with Administrator Cyril Inneh.

During visit LPA corrected the following to amend

1. LIC9099C, and LIC9099D page for Complaint Control #26-AS-20260227084309, on 03/26/26

2. LIC809C for Case Management Legal Non Compliance visit on 03/26/26

3. LIC809C for 1 year required visit conducted on 03/26/26.

LPA issued a civil penalty for repeat violation See LIC421FC for $250 for CCR 80087(a)(1) to correct an LIC421IM that was issued incorrectly for $1000 on 03/26/26

ADM agreed and understood to Civil Penalty issued on 03/26/26 see LIC9099D is for $250

LPA printed LIC421FC and issued to Facility and was signed and scanned into computer and copy was given to Administrator.

This report was reviewed with Cyril Inneh and a copy of the report and appeals rights was provided.