Facility Evaluation Report

While at the facility conducting investigation of a complaint (Control # 15-AS-20250711090435) and upon review of names of employees fingerprinted and associated to the facility and conducting interviews, Licensing Program Analyst (LPA) Delmundo learned that a staff (S1) who has been working at the facility is not fingerprinted. This was discussed with Mary 'Rose' Malekamu Mataele, administrator (ADM).

LPA also observed no Pre-placement Appraisal and LIC621 Client/Resident Personal Property And Valuables for residents.

Deficiencies are cited from Title 22 California Code of Regulations and listed on 809Ds. A $500.00 civil penalty is assessed and will continue for $100.00/day until corrected.

Deficiencies and plan and proof of corrections were discussed with ADM.

Exit interview conducted. Appeal Rights, LIC421BG Civil Penalty Assessment, LIC9098 Proof of Correction form and copy of this report provided.