Facility Evaluation Report

On 07/07/2023, Licensing Program Analysts (LPAs) Arielle Pascua and Kesha Lewis arrived unannounced to this facility to conduct as Plan of Correction (POC) visit. LPA Pascua and Lewis were greeted by staff member, Norma Borgus and asked to call the Facility Designated Administrator, Julian Hawes to let him know that CCL was present at this time. LPA Pascua was informed that FDA Hawes could not make the visit and and asked LPAs to continue the visit with SM Borgus. Current Census was 4.

The purpose of this visit was to follow up on the prior deficiencies and plan of corrections that were due on 06/30/2023 from a prior visit conducted on 06/29/2023.

As of the date of this visit, 07/07/2023, the department had not received any forms or documents to support the plan of the correction and has not been completed by this facility and its designated Administrator at this time.

An immediate civil penalty in the amount of $1,500 was assessed for violations of 80044(a)(2) and 85064(j)(3). This civil penalty was due to failure to correct the Plan of Correction by the POC date on 06/30/2023. The Facility Designated Administrator was informed that the civil penalty will continue to accrue $100 per day per violation until the deficiency is corrected.

An exit interview was conducted, a copy of this report, and appeals rights was provided to the Facility Designated Administrator,Julian Hawes. An electronic email read receipt confirms receiving these documents.