Follow-up on corrections·May 21, 2021

Licensing Program Analysts (LPAs) Javina George and Yolanda Delgado conducted a case management deficiency visit. LPAs George and Delgado identified themselves, and explained the purpose of the visit. LPAs were greeted and granted entry by caregiver Rebecca Phipps. At the time of the visit there were 2 staff present, and 8 residents at the facility. The administrator Christopher Tanabe All residents were observed to be in their rooms asleep, and or watching TV and eating. The facility was clean and odor free. The facility has a 2 day of perishables and a 7 day supply of nonperishable food items. LPAs George and Delgado observed that Staff # 1 (S1) and staff # 2 (S2) providing care were not be associated to the facility. Therefore, a deficiency will be cited and immediate civil penalties of $1000 will be assessed. An exit interview was conducted via telephone with Administrator Christopher, and a copy of this report, 9099D, and LIC421BG appeal rights were provided to Rebecca to provide to Administrator upon his arrival.