Follow-up·May 19, 2022

Licensing Program Analyst Carmen Odom conducted an unannounced Case Management visit. LPA met with Staff member Vi Khy, Director was on vacation, to discuss the Lead Sampling Testing conducted on 04/23/22. Staff was advised on 05/16/22 that the Lead Sample Report was to be posted. LPA confirmed that Staff had posted the Lead Sample Report. Staff stated the outlet with high levels of Lead are inoperable. They have made the kitchen faucet/outlet that tested with high levels of Lead inoperable with plastic bag wrapped around the faucet, tapped all around and a sign posted \342\200\234do not use\342\200\235. The outlet is in room#1 temporarily closed off until the they replace and retest the kitchen faucet. Source of drinking water is 2 large igloo water jugs; the jugs are refilled from outlets in room#2 that tested negative for Lead. Staff stated they have ordered the replacement faucet, when the replacement faucet arrives, they will have it retested for Lead. Based on LPAs record reviews the following violation was observed and is being cited in accordance with California Code of Regulations Title 22, Division 12, Chapter 3, Section 101238(a) Buildings and Grounds is being cited on the attached LIC 809D. Exit interview conducted and report was reviewed with the facility representative Vi Khy. A notice of site visit was given and must remain posted for 30 days. Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.