Follow-up on corrections·May 24, 2024

Licensing Program Analyst (LPA) Simi Rai is conducting a case management visit as a result of finding information during today's complaint investigation. LPA Rai met with Administrator (ADM) Elizabeth Bautista. LPA Rai observed 5 residents and 2 staff at the facility. During today's visit, LPA Rai observed Staff (S3) leave the facility as his/her shift was ended. S3 was not associated to the facility. During LPA's investigation interviews with S1 and S2, S1 and S2 were not associated to the facility. S1 and S2 stated they both started working on Saturday, May 18th, 2024. S1 and S2 stated they provide care and supervision to the residents, such as but not limited to assisting residents with feeding, bathing, grooming, and incontinence care. LPA Rai verified S1 and S3 do have a California criminal record clearance but are not associated to the facility. ADM stated S2 does not have California criminal record clearance because S2 is shadowing the care staff and will be leaving the facility tomorrow. ADM stated S1 and S3 are care staff and provide care and supervision to the residents at the facility. LPA Rai educated ADM on Title 22 CCR 87355 Criminal Record Clearance wherein all individuals prior to working, residing or volunteering at the facility need to have a California criminal record clearance and ensure they are associated to the facility. During visit, Administrator signed up on Guardian to set up an account to be able to associate and disassociate individuals who are working, residing or volunteering at the facility. Continuation on LIC 809-C, page 1 of 2. Page 2 of 2. Deficiencies are being cited per California Code of Regulations, Title 22. See LIC 809-D. A civil penalty is being assessed for the amount of $1500. For S2 working in the facility for more than 5 days without receiving a California criminal record clearance, the civil penalty will be for $500 ($100 per day x 5 days = $500). For S1 and S3 working at the facility without associate and California criminal record clearance transfer, the civil penalty will be $1000 ($100 per day x 5 days = $500 for two individuals). See LIC421BG. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. This report was reviewed with Administrator Elizabeth Bautista and a copy of the report and Appeal Rights were provided.