Facility Evaluation Report

**This is an amended report. POC due date is amended to reflect correct date.**

Licensing Program Analysts (LPAs), Mayra Cota and Blanca Gonzalez, conducted an unannounced Case Management visit. LPAs met with Lerisa Cantos, House Manager, and the reason for the visit was explained. LPAs contacted Carol Liess, Administrator via telephone call during time of visit and the reason of the visit was also explained

During today's visit LPAs, obtained copies of staff and client rosters and conducted record review for Client #1-8 (C1-C8). LPAs also inspected detached accessory dwelling unit (ADU).

The following was discussed with House Manager and Administrator at the time of visit:

Citations are being issued today for the following deficiencies:

CCR Section 85068.4(g) : Licensee did not ensure to request an exception for clients over the age of 60; there are currently three clients 60 and over residing at the facility.

CCR Section 85064(f) : Licensee did not submit a designation of responsibility prior to administrator's absence; administrator is currently on leave and licensee did not submit LIC 308.

CCR Sections 80020(a): Licensee failed to obtain new fire clearance after an ADU is completed which resulted in a Zero Tolerance violation and Civil Penalty was assessed.

Exit interview conducted with Lerisa Cantos, House Manager and a copy of this report, Appeal Rights, and LIC421IM CIVIL PENALTY ASSESSMENT – Immediate $500 was provided during time of visit and emailed to Administrator, per request.