Incident investigation·October 13, 2021

Licensing Program Analyst (LPA), Farhaan Sarangi arrived at Drake Terrace for the purposes of conducting an Unannounced Case Management-Incident inspection. LPA met with Administrator, Ricardo Romero, and was granted access into the facility. During the Case Management-Incident inspection, LPA observed resident and interviewed resident and Administrator. In addition, LPA requested the following documents be emailed to LPA's attention by October 15, 2021. Below is a list of documents to be sent to CCL: -LIC 500 -Staff disciplinary termination form -Statement from R1 -LIC 602 No deficiencies were observed or cited during today's Case Management-Incident inspection. Exit interview was conducted and a copy of this report will be emailed to the Administrator, Ricardo Romero.