Complaint Investigation Report

126801871-10-6-2022-21-AS-BMOS-CMAQHD-20221220111055

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

10/04/2022 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20221004173642

Staff not fingerprint cleared and/or associated.

At approximately 10:00AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct an investigation into the above allegation. LPA met with Administrator Daly Woytek, toured the facility, reviewed records and interviewed staff and residents. LPA reviewed staff schedules and compaired them to the background clearance records for the facility. Based on this record review, LPA observed S1 and S2, currently working at the facility, did not have a background clearance. LPA observed S3 and S4, no longer employed at the facility, had worked at the facility without a background clearance. A civil penalty is being issued in the amount of $2000.

Based on the Departments investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

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 Dale Woytek and Appeal rights were given.