Incident investigation·August 24, 2022

Licensing Program Analyst Ryker Heberle (LPA) conducted an unannounced case management visit at the facility on 08/24/2022. LPA was visiting the facility to follow up on an incident report indicating that a resident at the facility was experiencing burning like sensations. Resident returned to the facility with no updates. Staff on-site at the facility was said to not be fingerprint cleared in follow-up call LPA Christine Delores made to the facility. LPA arrived at the facility at 03:14pm. LPA met with facility staff member (S1). S1 stated that she was the only person currently working at the facility. LPA asked S1 whether or not they had received fingerprint clearance. S1 stated that they had not, but that they were going to go get it completed tomorrow. LPA checked guardian to determine fingerprint clearance status, which returned no results. Administrator Josephine Arcilla (Admin) arrived at the facility shortly thereafter. LPA informed Admin that no staff members without fingerprint clearance were allowed to be working at the facility, and that S1 would have to leave immediately. Admin stated that she understood and dismissed S1. LPA asked Admin how many days non-fingerprint cleared staff had been working at the facility, Admin confirmed that S1 had been working at the facility in excess of 5 days. A deficiency was cited during today’s visit, see LIC 809-D. A civil penalty is being assessed for the amount of $500 ($100 per day x 5 days = $500), for staff S1 working at the facility without fingerprint clearance. Please see LIC 421BG. Exit interview was conducted with Administrator Jesus Arcilla. This report, LIC 809-D, civil penalty, plan of correction, and appeal rights were discussed with Administrator Jesus Arcilla, and copies were provided.