Facility Evaluation Report

On 12/13/2022 at 1:30pm, Licensing Program Analysts (LPAs) Arielle Pascua and Jason Lund arrived unannounced to this facility to conduct as Plan of Correction (POC) visit. LPA Pascua and Lund were greeted by Norma Burgos and asked to call the Facility Designated Administrator, Julian Hawes to let him know that CCL was present at this time. There were two other staff members present, Myra Aguilar-Guzman and Resscurcion Del Rosario. Shortly after, LPA Pascua spoke to FDA Hawes via telephone and explained the purpose of the visit. LPA Pascua was informed that FDA Hawes could not make the visit and and refused for any other facility representative to sign paperwork. 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 10/04/2022 from a prior annual visit conducted on 08/30/2022 and case management visit conducted on 09/30/2022.

The department visited this facility on 12/01/2022 to access an immediate civil penalty and to inform the Facility Designated Administrator that a civil penalty will accrue $100 per day per violation until the deficiency is corrected. The department received the POC via email on 12/05/2022.

An immediate civil penalty in the amount of $1,600 was assessed for violations of Sections 85706(d)(1), 80087(a) and 80036 (e) for the time between 12/02/2022-12/05/2022. This civil penalty was due to not clearing the Plan of Correction (POC) by POC date 10/04/2022.

An exit interview was conducted via telephone, a copy of this report was emailed, LIC421FC, and appeals rights were provided to the Facility Designated Administrator, Julian Hawes via email.