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Facility Evaluation Report

Elle's Home, Hayward03/25/2026Licence 019200923

Capacity6
Census6
Date signed03/25/2026 04:47:55 PM
Name of licensing program analystAlicia Delmundo
Name of licensing program managerBennett Fong
The inspector’s account

While at the facility investigating a complaint (Complaint Control # 15-AS-20260319142321) and upon review of records and interviews, Licensing Program Analyst (LPA) Delmundo observed the following:

1. Staff (S1) who stated started working on January 8, 2026, is not fingerprint cleared.

2. Resident (R1) does not have Pre-Admission Appraisal.

Deficiencies are cited on Title 22 California Code of Regulations and listed on 809Ds. A $500.00 civil penalty is assessed for section # 87355(e)(2). Failure to submit proof of corrections by plan of correction due dates and any repeat violation within 12 month period may result in additional civil penalty.

Deficiencies, civil penalty, plan and proof of corrections were discussed with ADM.

Exit interview conducted. Appeal Rights, LIC421IM Civil Penalty, LIC9098 Proof of Correction form and copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction