Follow-up on corrections·October 4, 2022

Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to issues deficiencies observed. LPA met with staff Evangelica Dela Rosa who was informed of the purpose of the visit on 10/4/2022. LPA found through interview with Licensee that Staff #1 (S1) was a candidate for hire at the facility. Licensee stated that (S1) had not been fingerprinted and had not been at the facility. LPA interviewed a staff member who stated that S1 had been working at the facility in a resident’s room. LPA interviewed resident mentioned by staff, who stated S1 had been working and assisting her at the facility for the week of 09/11/2022 to 09/17/2022. LPA reviewed the Guardian roster for the facility and found that S1 was not listed, Licensee confirmed that he had not yet associated, hired, or fingerprinted this staff member. Therefore, based on staff and resident interviews, and review of staffing records it was found that a civil penalty will be issued for uncleared staff member who had resident contact. LPA will issue a civil penalty for $100 per day per person to the maximum of 5 days, resulting in $500 civil penalty. This will be documented on LIC421BG form along with LIC809-D and plan of correction. An exit interview was conducted where this report, LIC809-D, appeal rights, and LIC421BG were review with…Reports were provided to Evangelica Dela Rosa