Correction check·June 1, 2023

Licensing Program Analyst (LPA) Pang Lee arrived at the facility on 06/02/2023 at 12:30 AM to conduct an unannounced Plan of Correction (POC) visit. LPA Lee met with Charlene Saveligo, who stated that she is a caregiver. LPA Lee explained the purpose of the visit. The purpose of this visit is to follow-up on a plan of correction that were due 05/12/2023. During today's visit, LPA Lee asked to review residents and staff files and caregiver Charlene stated that she wanted LPA Lee to wait until the designation, caregiver Cleopatra Gardiner returns to the facility to answer and go over any questions that LPA Lee may have. Caregiver Charlene called caregiver Cleopatra and stated that caregiver Cleopatra will come to the facility shortly. LPA Lee toured and inspected the facility to ensure deficiency previously cited on 05/05/2023 have been corrected. During today's visit, LPA Lee toured and inspected the facility. LPA Lee observed the main bathroom located in the hallway to be locked. Staff 1(S1) unlocked that bathroom and when asked by LPA Lee why the bathroom was locked (S1) stated that they locked the hallway bathroom because it is for the staff use only. LPA Lee reviewed staff criminal record clearances and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared; however it was learned that staff 1 (S1) is not associated to the facility. Based upon this inspection, LPA Lee observed the following: 1. Deficiency cited under Title 22 Regulation 87303(c) has been cleared. Licensee complied with the terms of the POC by POC due date. A POC letter was generated and provided to the licensee. 2. Deficiency cited under Title 22 Regulation 87506(b)(10)) has not been cleared. Licensee did not complied with the terms of the POC by POC due date. 3. Deficiency cited under Title 22 Regulation 87411(c)(6) has not been cleared. Licensee did complied with the terms of the POC by POC due date. Continued on LIC 809-C An immediate $500.00 civil penalty shall be assessed on June, 1, 2023; based on observation and review "Facility is not adhering to personnel requirements/background association of employees." Violation of California Code of Regulations Section 87411 (g) was assessed on 06/01/2023 because the licensee did ensure that (S1) was associated to the facility prior to working. As a result of this POC visit, the facility is not in compliance with Title 22 Regulations, and the deficiencies can be found on the LIC 809-D page. An exit interview was conducted, and a copy of these LIC 809, LIC 809-C reports, LIC 809-D page, LIC 421IM and Appeals rights were provided to the facility.