Facility Evaluation Report

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct a Case Management Deficiencies inspection. LPA was greeted and granted entry by staff. LPA met with Caregiver August Rebollar and discussed the purpose of the visit.

LPA was informed that the Administrator (AD) will not be coming to the facility and that the caregivers were on their way to the doctors and could not assist LPA during the visit. LPA inquired about the one caregiver at the facility. Staff #1 (S1) informed LPA that they were hired through an agency and have only been at the facility for one day. S1 informed LPA that they were not given instructions before being left alone with the residents so they did not know how to assist LPA. LPA did not observe that S1 was background cleared and associated to the facility. An immediate civil penalty was assessed at the time of the visit. LPA waited for staff to return to the facility and observed S1 leave the facility property.

The AD informed LPA that they cannot assist at the facility and that they do not have anyone that they can send over to help. AD informed LPA that they will call the caregivers and have them return to the facility as soon as possible to assist LPA. LPA did not observe a designated facility representative LIC 308 with an active Administrative certificate holder.

LPA observed the Accessory Dwelling Unit (ADU) in the backyard to be locked and made inaccessible to residents and staff. LPA inquired about opening the ADU for inspection and was denied access. LPA was informed that staff do not have keys due to it being used by the AD. LPA informed staff that the entire facility is under inspection to licensing and needs to be accessible. LPA was unable to clear the Plan of Correction that was cited on October 22, 2025, for regulation 87204(a) due to not having access and observing the inside of the ADU. An immediate civil penalty was assessed at the time of the visit.