Facility Evaluation Report

Licensing Program Analyst (LPA) Renee Campbell arrived unannounced to conduct a Case Management regarding completed client files. LPA Campbell met with Administrative Team Lead, Jessica Villasenor and explained the purpose of the visit.

During the course of the visit, LPA Campbell requested the files for Sequoia Home. The files for the other three facilities in the community had been reviewed during recent annual inspection visits. During Sequoia Home's annual inspection, LIC 602's were reported to still be at the doctor's office per Jessica Villasenor and could not be reviewed at that time. LPA Campbell asked Jessica Villasenor when the rest of the 602's could be picked up and she replied they could be received in a week.

LPA Campbell returned during today's vist and requested and reviewed the medical files for the two clients at Sequoia Home with missing 602's. Forms were either still missing or incomplete for R1 and R2 per Jessica Villasenor.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, the following deficiency is being cited on the attached 809-D during this visit.

An exit interview was conducted, and copies of the report and appeal rights left.