Senior Care Records.

Facility Evaluation Report

San Luis House, Novato10/21/2021Licence 216800881

Capacity6
Census5
Date signed10/24/2021 11:01:40 AM
The inspector’s account

Licensing Program Analyst (LPA) Fernandes-Goes conducted a case management inspection due to complaint investigation. LPA arrived at the facility was welcome by staff Veronica S. There is a total of 5 clients with 2 in day program.

During this visit there were 3 staff present at the facility, however; 1 out of 3 is not associated to the facility. Staff S1 has fingerprint clearance, not associated to the facility according with Guardian Employee Roster printed on 10/21/2021. Staff S1 stated that she works at a sister facility which S1 is associated to. Facility has staff S1 working here today due to staff schedule change.

Immediate Civil Penalties are being assessed in the amount of $100 due to staff not being associated to the facility.

*****Total Civil Penalties issued today in the amount of $100.00

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.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction