Follow-up·December 30, 2024

Licensing Program Analysts (LPAs) Simi Rai and Marcela Yanez conducted an unannounced visit to conduct an investigation visit for a complaint received on 12/23/2024. During the complaint investigation, a case management was conducted due to deficiencies observed during the investigation process. LPAs met with Administrator Dieu-Qui H Nguyen. During today's visit, LPAs observed 2 staff at the facility and providing care and supervision to the residents in care. S1 was preparing snacks for the residents and S2 was providing incontinence care to residents. LPAs reviewed LIS 536 Facility Personnel Report Summary for the facility dated 12/30/2024. Administrator stated both staff had Criminal Record Clearance and provided the names of the 2 staff. LPAs were able to verify S1's name on the LIS 536 but the name S2 provided was not on the LIC 536. Administrator provided a different name for S2 than S2 stated to LPAs. Administrator stated S2 has obtained a Criminal Record Clearance. LPAs requested staff file for S2. Administrator was not able to provide a complete staff file for S2 which would include S2's letter of Criminal Record Clearance. The only document from S2's staff file Administrator was able to provide for LPAs to review was the training completed for 2024. Administrator stated S2's file is maintained out of the facility in a separate location. Administrator did not maintain S2's staff file at the facility and was not available for licensing agency to review. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Deficiencies are being cited per California Code of Regulations, Title 22. See LIC 809-D. This report was reviewed with Administrator Dieu-Qui H Nguyen and a copy of the report and Appeal Rights were provided.