Facility Evaluation Report

On 9/25/2024 at 2:10pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced Case Management visit. LPA met with Marjorie Belencion, Caregiver. Administrator, Donnie Aloot, arrived at 2:25pm and LPA explained the purpose of the visit.

LPA received an personnel report (LIC500) on 9/13/2024. Only one (1) of six (6) staff on the LIC500 were on the facility roster in guardian. LPA conducted the visit to affirm if staff on the LIC500 was employed and working at the facility. LPA observed two (2) of the staff (S2 and S3) were working during the visit.

LPA observed the following deficiencies during visit:

At 2:20pm, LPA observed medicine cabinet unlocked with medication inside.

At 2:45pm, LPA observed S2 was not associated or fingerprinted to the facility.

At 2:45pm, LPA observed S3, S4, S5, and S6 were not associated to the facility.

At 3:10pm, LPA observed R1 with half bed rails.

Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted. A copy the appeal rights and the report provided.