complaint·July 14, 2023

During the investigation LPA reviewed documents including the Licensing Information System (LIS) Facility Personnel Report Summary dated 07/12/23. Per LIS Facility Personnel Report Summary S1 is not associated and/or cleared to work at the facility. Based on LPA observations and the interviews which were conducted, the preponderance of evidence standard has been met, therefore the following allegation: Female non-staff is sleeping in common area (living room couch) is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D A $500 Civil Penalty was issued. AD agreed to email the Physician Report (LIC602) and Admission Agreement for three residents in care by 07/17/23. An exit interview was conducted with AD Dela Cruz and a copy of this report along with the Appeal Rights were provided at the time of this visit. In the kitchen LPA observed that the countertop tile is missing grout and therefore is growing mold. At 9:18 AM LPA tour the back yard and observed a ladder, boxes full of clothes, a bicycle, a treadmill, and plastic bin containers stack on top of each other. On the side of the house leading to the exit gate LPA observed empty cardboard boxes stack on top of each other, a ladder, a rug, a portable propane tank, paint containers on top of each other and plastic bags fill with litter. Based on LPA observations and the interviews which were conducted, the preponderance of evidence standard has been met, therefore the following allegation: facility is clutter and unsanitary is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D An immediately $250 Civil Penalty was issued today for a repeat violation cited on 08/25/22. An exit interview was conducted with AD Dela Cruz and a copy of this report along with the Appeal Rights were provided at the time of this visit.