Facility Evaluation Report

Licensing Program Analyst s(LPAs)Bertozzi and Nakagawa met with Business Office Manager, Tristan Amir to address deficiencies that were noted during a complaint investigation. Executive Director Ric Pielsitck was available by phone.

During a complaint investigation LPAs were provided an Employee Roster and LPAs learned that facility has one staff who is not fingerprinted and three other staff were identified as being cleared but not associated to the facility.

Immediate Civil Penalties are being assessed in the amount of $400 due to one staff not being fingerprinted and three staff not being associated to the facility.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.