Complaint Investigation Report

LPA conducted interviews between 3:39 p.m. - 4:05 p.m. with two out of four clients present at the facility and S1. At 4:14 p.m. LPA conducted an interview with Administrator and the Licensee Dolly. LPA reviewed facility records and obtained pertinent documents for the investigation. LPA reviewed Facility Personnel Report Summary and identified two (2) out of four (4) staff present have a pending status and were observed to be providing assistance with client care. Administrator Chary reviewed Guardian records and determined staff #2 (S2) and staff #3 (S3) have an in-progress status. Administrator provided records to LPA and records indicate S2 and S3 are fingerprint cleared at Wauls Small Family Home a licensed facility. According to the Administrator they made the association and were informed by Guardian clearance status would transfer to this facility. Based on record review, S2 and S3 have background clearance, but have pending status for association to this facility therefore the allegation is substantiated at this time.

Per the California Code of Regulations (CCR), Title 22, Division 6, Chapter 8, the following deficiency was observed and cited (Refer to LIC 809-D). A civil penalty was assessed (refer to LIC421BG).

Deficiencies cited. Exit interview conducted, Appeals rights provided. Report signed and delivered.