Facility Evaluation Report

Licensing Program Analyst (LPA) Erica Mosley conducted a Case Management - Deficiencies visit due to a deficiency observed during a complaint investigation.

At 10:10 a.m. during a complaint investigation LPA Mosley was informed by facility staff and acting Administrator that they have been Administrator since 09/01/2025. Upon review of the Guardian Background Check System the Administrator was observed to have fingerprint clearance but was not associated to the facility. LPA informed the Administrator that employees must obtain a fingerprint clearance and be associated to the facility prior to working, residing or volunteering in a licensed facility. LPA informed the Administrator that a civil penalty in the amount of 500$ (1 Employee x 100$/day x 5 days [maximum of 5 days] = $500) will be assessed on today’s date (09/05/2025) for not having submitted a criminal record clearance transfer request.

At the time of the visit the Administrator provided the LPA with the required documentation and was associated to the facility. Plan of Correction (POC) cleared on site.

Pursuant to Title 22, CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Civil penalties were issued in the amount of $500. Administrator was informed that failure to correct deficiencies may result in additional civil penalties. Exit interview conducted, report issued, and appeal rights provided.