Follow-up·October 11, 2022

At approximately 2:10PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Case Management - Other Visit, and met with Health and Wellness Director, Victoria Mozaffari. The purpose of the visit is to follow up on two missing documents needed to establish Regional Director of Operations, Dave Peper, as the Administrator of Cogir of San Rafael, until the following occurs: An individual is hired as Executive Director Victoria Mozaffari receives their Active Administrator's Certificate and is processed as the Administrator. LPA and Health and Wellness Director discussed the missing documents ( LIC 503 Health Screening Report - Facility Personnel and Proof of a Negative TB Test . ) LPA spoke with Regional Director of Operations over the phone and confirmed that an appointment has been made to complete the requirements. The following documents to be submitted to Community Care Licensing (CCL) by the end of business on Friday, 10/11/2022 LIC 503 (Health Screening Report - Facility Personnel) Proof of a Negative TB Test Facility understands that all Administrator paperwork will need to be re-submitted for whomever is hired as Executive Director. No Deficiencies cited during visit.