Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a case management-incident inspection, on 8/26/25 at approximately 2:20pm, and met with Administrator Eddah Kiharra.

This case management inspection is being conducted due to observed deficiencies unrelated to a complaint inspection of earlier today.

LPA reviewed client files, C1 & C2. LPA obtained copies as requested of client file documents. LPA interviewed staff, and other related parties regarding the incident reports.

Per file reviews, LPA observed the facility did not report client incidents to the Department as required by regulation. There were three (3) client incident reports dated 8/17/25, three (3) client incident reports dated 8/21/25, and one (1) client incident report dated 8/25/25. None of these reports were received by the Department from the Licensee. as required..

This deficiency will be cited, 80061(a) Reporting Requirements- Each licensee or applicant shall furnish to the licensing agency reports as required by the Department, including, but not limited to, those specified in this section , see LIC809D.

Per file reviews, LPA observed that a written 30-day notice of eviction, to client C2, had not been reported and a copy provided to the Department, as required by regulation. This deficiency will be cited, 80068.5 (e) Eviction Procedures- The licensee shall mail or fax to the Department a copy of the 30-day written notice in accordance with (a) above within five days of giving the notice to the client, see LIC809D.

Deficiencies cited from the California Code of Regulations, Title 22,

Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties.

Exit interview conducted with the Administrator, Eddah Kiharra.

Appeal rights provided to the Administrator.