Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted a case management visit in conjunction with a complaint that has the control # 28-AS-20251007152115.

During record review of the facility staff associations on the Guardian website at the time the complaint was filed on 10/7/2025, it was revealed that Staff #1 (S1) was not associated to the facility while working as a caregiver. S1's association status in Guardian stated that he was "In Process" of being associated, but was not yet eligible to work. It was revealed that S1 had worked at the facility from February of 2025 - 10/16/2025 while not being fully associated. In a letter sent by Guardian to S1 on 7/22/2024. It reads that S1 had an "Ineligible Fingerprint Submission" due to the fact that S1 is ineligible due to a previous denial of a criminal record exemption or exclusion action, and therefore was not allowed to work with residents or be present in an agency licensed by the department.

The related deficiency is cited on the LIC809D page. A copy of this report along with the appeal rights were provided.