Follow-up·February 2, 2023

Licensing Program Analyst (LPA) Ruth Martinez conducted a case management visit on today's date. LPA arrived at facility was greeted and granted entry by caregiver. LPA met with Francisca Diaz, Administrator and explained the nature of the visit. On 01/23/2023 LPA Alejandre received a call from Administrator informing department that the facility has all private rooms, and a wall was placed dividing a family room without seeking CCLD prior approval or building permit. LPA Alejandre advised Administrator to submit an LIC200, proposed floor plan and a check for the fees to the department. Administrator informed that license is currently licensed under an individual, however Administrator indicated they had incorporated. During today’s visit LPA toured the physical plant of the facility with Administrator and observed facility to have two family rooms, one in the main entry of the facility and another one adjacent to it. Administrator stated a wall was put up to split the room and make a private bedroom. LPA observed the room to be empty with no furnishing or occupancy. LPA advised Administrator that bedroom cannot be occupied until process is finalized and fire clearance is granted. LPA Martinez reviewed the facility floor plan and it does not match the actual physical plant. LPA was informed that Administrator submitted the LIC200, proposed floor plan and check to CCLD on 01/24/2023. Administrator provided a copy of the receipt from the department. Administrator showed LPA Martinez an LIC309 that was mailed into CCLD dated 11/27/2019 for the LLC that was created. LPA Martinez explained that in order for the facility to be under the LLC that a change or ownership application needed to be submitted to the department. Administrator indicated she never received any call or correspondence from the department, but she will call the centralized applications bureau and verify. Continued on LIC809-C In the event that the paperwork is not filed or needs to be filed she will submit the required to the department no later than March 02, 2023. Based on this inspection, deficiencies were observed at this time in the areas evaluated per Title 22 Division 6 of the California Code of Regulations . See LIC 809-D for deficiencies. This report was reviewed with Administrator and a copy of this LIC809, LIC809-D report was provided and left at facility. Appeal rights reviewed, and a copy provided.