Follow-up on corrections·August 17, 2023

Licensing Program Analysts (LPAs) Emily Peraldi and Martha Arroyo conducted a Case Management – Deficiencies to issue citations for deficiencies observed during an unrelated complaint investigation. Entrance interview conducted. Prior to visit, LPA Peraldi printed out the facility personnel report summary from the Licensing Information System (LIS). Upon arrival, it was revealed Staff #1 (S1) is the main caregiver during the week. Per record review, conducted by LPAs on the Guardian website, S1 does not have fingerprint clearance. Inter views with the Administrator revealed that S1 started working at this facility on July 27, 2023. The Administrator explained that S1 will obtain their fingerprint clearance. The LPAs reminded the Administrator that staff that are not fingerprinted or are not associated to the facility cannot be working at the facility. The Administrator stated that the facility will ensure that all staff will have a criminal record clearance and are associated to the facility prior to working at the facility. Additionally, the LPAs had a conversation with the Administrator regarding the Unlicensed complaint that the Department received on 08/14/2023 located at the accessory dwelling unit (ADU) at the back of the facility. The Administrator stated that the ADU is not licensed and is an independent living facility and that she is not part of the operation. The Administrator explained that the Operator of the independent living facility has their own lease agreement and only accepts tenants who do not require aspects of care and supervision. Information obtained and reviewed from investigation conducted on 08/17/2023, revealed that one (1) out of three (3) tenants (Tenant #1) were found to require assistance with activities of daily living such as but not limited to medication management, bathing, and dressing. Furthermore, record review and interviews conducted revealed the Administrator misrepresented the facility by accepting a resident who required care and supervision and was placed in the independent living facility located in facility’s ADU. Continued on LIC 809-C. During the interview with the Administrator, it was revealed that one of the residents was hospitalized on July 23, 2023 and the Administrator did not send an incident report regarding the hospitalization to the Department. The LPAs reminded the Administrator that a written report shall be submitted to the licensing agency within seven days of the occurrence of any of the events such as a hospitalization. Pursuant to Title 22 of the California Code of Regulations Division 6, Chapter 8, the following deficiencies were cited (refer to LIC 809-D). Civil Penalties assessed in the amount of $500. Failure to correct the deficiencies may result in additional civil penalties. Exit interview conducted, today's reports and appeal rights were provided.