Correction check·September 8, 2025

On 9/8/25, Licensing Program Analyst (LPA) Cynthia Tamayo made a case management plan of correction follow up and deficiency visit. LPA identified themselves upon arrival, stated the purpose of the visit. LPA asked to meet with the administrator Alita Waqalala (S3) but was told they were out sick. LPA called S3 via phone and left a voimail and email requesting a call back. LPA met with Misivono Qadroka (S1). LPA toured the facility, including resident bedrooms, bathrooms, upstairs staff room, common areas, and backyard. LPA observed the following deficiencies during this visit: LPA reviewed staff roster and observed S2 and S4 are associated to the facility. POC letter generated and provided to the facility. LPA did not received a completed staff file for new staff by POC due date of 9/5/25. Facility will receive civil penalty due to failure to correct. There were two staff, S2 and S4. S4. S4 has a cleared criminal background clearance. S4 stated they started working at the facility on 9/6/25. S3 faxed over S4's file to the facility. Upon record review, there is not a complete staff record for S4 either. Exit interview conducted and a copy of this report and appeal rights were left at the facility. LPA observed deficiencies and the facility is not in compliance with Title 22 Regulation, a civil penalty for failure to correct and LPA return to complete a follow up case management. An exit interview was conducted with S1 and a copy of these LIC 809 reports 421FC, and Appeals rights were provided to the facility.