Complaint Investigation Report

126801871-8-4-2022-21-AS-BMOS-CH6UHR-20220810153621

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

08/02/2022 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20220802120803

Unqualified Administrator working at facility

At approximately 10:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility, unannounced, to open an investigation into the above allegation. LPA met with Executive Director Tiffany Blake and reviewed documents. Tiffany told LPA she submitted the administrator application on 10/20/2021. Then again, after taking and passing the Administrator test. Tiffany told LPA that her payment was returned due to it being the wrong amount. A new check, for the proper amount, was sent, which was also returned, due to the date being past the 30 day time frame from taking the test. Although it appears there was some miscommunication between Tiffany and the Administrator certification unit, no application was received, therefore no Administrator certificate was issued. LPA discussed the steps that need to be taken to correct this issue.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Tiffany Blake and Appeal rights were given.