Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a case management inspection after a complaint inspection was completed; During the course of the Department's investigation, a deficiency was identified regarding a required report of serious incident.

Deficiency will be cited, see below. Administrator has agreed to provide in-service training to staff to avoid this deficiency in the future.

Deficiency citation, 80061(a)(b) 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. Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in (2) below shall be submitted to the licensing agency within seven days following the occurrence of such event, see LIC809D.

The following deficiencies is cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties.

Exit interview conducted with the Licensee/Administrator.

Appeal rights provided to the Administrator.