complaint·June 22, 2025

During a subsequent visit conducted on 06/21/2025, LPA interviewed Staff S1-S5, interviewed Residents R1-R10, and received documents pertinent to the investigation. The following documents were received and reviewed an Administrator packet submitted on 06/06/2025 to Community Care Licensing (CCL). The investigation revealed the following: Allegation: Facility is without an Administrator The allegation alleges that the former Administrator left in April 2022 and there has not been a replacement. During the facility visit, LPA meet with the designated person listed on the Designation of Facility Responsibility (LIC308) while the current Administrator is on leave. During record review, LPA received and reviewed the following documents for the Administrators who are filling in while the current Administrator is on leave. The documents include the following forms: Application For A Community Care Facility or Residential Care Facility for the Elderly License (LI200) dated 06/04/2025 indicating an administrator change, letter informing (CCL) of the change dated 06/04/2025, Personnel Record (dated 06/01/2025), Health Screening (LIC503) dated 05/30/2025, copy of California Driver License, Criminal Record Statement & Out-of-State Disclosure (LIC508) dated 05/30/2020, Department of Social Services Clearance Background Check, dated 02/23/2023, Administrator Certificate valid till 03/24/2027, Designation of Facility Responsibility (LIC308), resume, college transcripts, First Aid certificate valid till 11/19/2026, an updated LIC500, and a copy of the mailing slip for the package to be sent. During interviews with Staff S1-S5, on 06/21/25 from 2:30PM to 4:15PM, were asked if the facility currently has an Administrator, five (5) out of five (5) stated yes, the facility has an administrator. During interviews with Residents R1-R9, on 06/21/2025 from 10:20AM to 1:29PM, were asked if the facility currently has an Administrator, ten (10) out of ten (10) stated yes, the facility has an Administrator and S1 is covering for the Administrator while they are out. During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated . During today’s visit, LPA did not observe or cite any deficiencies. An exit interview was conducted with Resident Service Director, Stephanie Roldan , and a copy of this report was provided.