Follow-up on corrections·October 21, 2024

Licensing Program Analyst (LPA) Rose Ruppert conducted an unannounced case management visit at 1:30 PM to follow up on an email received by the Centralized Complaint and Information Bureau (CCIB) on October 14, 2024. LPA was greeted and granted entry into the facility by the Concierge and met with Sara Modugno, Administrator (AD). The purpose of the visit is to verify there is an Administrator at the facility since the Administrator on-file no longer worked with this facility as of February 19, 2024 per Human Resources. Upon interview with current Administrator, who spoke with Chief Executive Officer (CEO) Robert Goerzen via phone, CEO recollects handing the paperwork and speaking to LPA Andrea Mendivil in February 2024 to add Gina Kolb as the Administrator. During this time the facility completed paperwork for a change of capacity but not a change of administrator. Upon review of our database, LPA Ruppert could not corroborate this since there was no supporting documentation that LPA Mendivil visited between January to March 2024. Facility will search their files for the paperwork regarding a change of administrator in February 2024. LPA obtained and reviewed a new and signed LIC 200 form to change the Administrator to Sara Modugno and was given a copy of the Administrator's certificate which expires on September 2, 2026. The following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Sara Modugno, Administrator and a copy of this report was given to the facility along with a copy of the LIC 809-D and Appeal Rights.