Follow-up·August 2, 2022

Licensing Program Analyst (LPA) Carmen Lopez made an unannounced visit to the facility to conduct an annual required licensing inspection and provided facility with additional guidance. LPA identified herself and was granted entry by Caroline Belarmino, caregiver. LPA met with caregiver Belarmino and discussed the purpose of today’s visit. Licensee Jesusa Pascua later arrived and joined the visit. During today’s visit, LPA toured the facility accompanied by caregiver Belarmino. LPA provided guidance to Licensee Pascua on Title 22, Division 6, Chapter 8, Section 87211 Reporting Requirements, resident records and provided a copy of the Records to be Maintained at the Facility (LIC311F) form. Based on today’s inspection no deficiencies were cited. An exit interview was conducted with Licensee Pascua. A copy of this report, along with the Licensee Rights (01/2016) was provided to Licensee Pascua at the conclusion of the visit. The signature below serves as confirmation of receipt of these documents.