Follow-up on corrections·December 14, 2023

Licensing Program Analyst (LPA) Hansen arrived unannounced to conduct a case management on mandated reporting requirements at facility and was welcomed by staff Maryellen. Administrator Kari Oxford was contacted and arrived an hour and a half later. On 12/8/2023 Community Care Licensing (CCL) received information from an outside agency involving resident (R1), being assaulted by a caregiver. The facility has not notified licensing agency as required by regulation 87211(a)(1)(D), within 7 days of incidents. LPA was informed by Administrator, CCL had not been provided required SOC 341 documentation due to lack of communication within facility. LPAs interview with administrator and additional documents obtained regarding incident and involved parties, learned agency caregiver/individual (I1) had worked at facility for approximately three months with November 27, 2023 being the last day at facility. LPA located I1 on guardian check list, showing I1 has not been background cleared by DOJ. LPA is issuing citation for not having I1 background cleared by DOJ 87355(e)(1). Based on records review, LPA reviewed incident report logs for this facility, and it was determined that incident reports were not submitted to CCL. Last incident report submitted 11/21/2023. Administrator could not provide proof that incidents were reported to CCL. * ****Civil Penalties for $500.00 for not having DOJ clearance of Individual/Caregiver Appeal of Rights Given. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided