Follow-up on corrections·December 21, 2021

Licensing Program Analysts (LPAs) Elsie Campos and Ashley Smith conducted an unannounced Case Management-Deficiencies inspection visit at the facility today due to deficiencies observed during the investigation of complaint control #29-AS-20211217161220. During a visit conducted on 12/16/2021, it was observed that Staff #1 (S1) was not associated to the facility, and a file review confirmed that S1 started working at this facility on or about 08/04/2021. A civil penalty was issued on 12/16/2021, noting that S1 could not return to the facility until the association was complete. During today's visit, S1 was observed to be working at this facility. The LPAs reviewed the Caregiver Background Check System during today’s visit and observed that S1 was not associated to this facility. Per the staff schedule, S1 worked on 12/17/2021, 12/18/2021, and today, 12/21/2021. At the start of the visit, the LPAs observed the posted Administrator Certificate for the Administrator Pink Tillman III (#6009095740) to be expired. The LPAs checked the Administrator Application Status online and did not observe the Administrator’s name on either the active or pending list. Throughout the visit, the LPAs observed signs alerting staff and residents that ‘Janyce Pink’ was the new Assistant Administrator, effective immediately. However, S2 is not associated to this facility, nor does the Department have any paperwork, designating S2 as an Administrator. An internal file review revealed that this facility sent in an LIC9182 Caregiver Background Transfer Request on 12/20/2021. However, this facility did not include a completed LIC508 Criminal Record Statement or clear copy of S2s ID to complete the association. The date of employment on the association document was 11/23/2021. As of today, S2 is fingerprint cleared but is not associated to this facility. Interviews revealed that S2 began working in this facility on or about BLANK. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted, today's reports and appeal rights were issued. Civil penalties assessed.