Follow-up on corrections·February 14, 2025

In conjunction with control number 31-AS-20250207131924 complaint visit, Licensing Program Analyst (LPA) Evelin Rios did an unannounced CASE MANAGEMENT - Deficiencies visit. A case management report is being issued today in conjunction to the complaint visit report for observed deficiencies not related to complaint. LPA met with Susan Park the Executive Director. During the course of complaint investigation, interview with Executive Director and review of Personnel Report (LIC500) revealed staff #1 (S1) is not on the report. According to ED, S1 was hired as a caregiver from a temporary agency. According to interviews S1 has worked for the facility for over a year in the capacity as receptionist and caregiver. Based on staff interviews, at least on one occasion S1 has been alone to provide care and supervision to one (1) resident. Review of Guardian Background Check System and Licensing information System (LIS) S1 is background cleared but not associated to the facility. Per the California Code of Regulations (CCR), the following deficiencies were observed and cited (refer to LIC 809-D) and a Civil Penalty assessed (refer to . Exit Interview Conducted / Appeal Rights Discussed / A Copy of Report Issued.