Community Care Licensing

Document Has Been Signed on 11/28/2023 04:16 PM - It Cannot Be Edited

FACILITY NAME:	UNITED CEREBRAL PALSY, PROGRAM WITHOUT WALLS		FACILITY NUMBER:	397202975
ADMINISTRATOR:	JOANNE JOHNSON		FACILITY TYPE:	775
ADDRESS:	6709 PLYMOUTH ROAD, SUITE C		TELEPHONE:	(209) 956-0290
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY: 45		CENSUS: 24	DATE:	11/27/2023
TYPE OF VISIT:	POC	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Amanda Hart		TIME COMPLETED:	02:42 PM

NARRATIVE

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The following deficiencies, initially cited during a visit on 10/24/2023, have been cleared: Section Cited: 82092.2 Date Due: 11/07/2023 Plan of Correction: Licensee/Administrator shall submit an updated health care plan for all residents with a restricted health conditon. This shall be done by POC date 11/07/2023. Corrections: Cleared By Visit Clearance Date: 11/27/2023 LPA reviewed the incident report sent on 11/09/2023, The report was sent to CCL, VMRC and Local law enforcement regarding the allegation of sexual abuse. The local police department investigated and deemed the allegation to be unfounded. The investigating Officer did not feel that the allegation required further investigations and APS was not contacted. According to R1's IPP dated 11/22/22, R1 has a history of making false allegations, however these allegations or delusions continue to need to be reported to Ombudsman, CA. Public Health and Valley Mountain Regional Center to rule out any supposed abuse. LPA advised the program to contact CA. Public Health to report the incident. Exit interview held with Administrator and a copy of report given at the conclusion of the visit.

SUPERVISORS NAME: Lisa Rios LICENSING EVALUATOR NAME: Albert Johnson LICENSING EVALUATOR SIGNATURE: DATE: 11/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/27/2023