Facility Evaluation Report

On today's date, Licensing Program Analyst (LPA) Michael Tea conducted this case management in conjunction with the continued Complaint visit Control #:22-AS-20230203140953. LPA Tea met with Caregiver (CG) Quy "Anna" Mai and discussed purpose of today's case management visit - Deficiencies visit. Administrator Ngoc "Nick" Mai was not present but LPA spoke to AD Mai over the phone.

During the visit LPA Tea was greeted and granted entry by a new staff, Sau Nguyen. LPA observed that AD was not present and just the staff was alone with the residents at the facility. LPA was able to talk to AD Mai over the phone and asked where he was. AD Mai said he is far away from the facility in San Bernardino obtaining cooking utensils for the facility and that the residents are being supervised by the present staff who is AD Mai's cousin, who he plans to hire as a caregiver for the facility. AD Mai said that he was testing him out with the residents. LPA Tea asked AD Mai if he had the staff fingerprinted and passed background clearance. AD Mai said he just started the paperwork. LPA explained that all staff whether test trial or not is required to have full background clearance to be at the facility. AD Mai understood and said that he will have his sister, Quy "Anna" Mai an on-call caregiver come to facility within in half an hour.

LPA observed there is not enough staff to care for residents, especially when AD Mai is away.

Based on this inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC 809-D for the deficiencies.

An exit interview was conducted with Caregiver staff Quy "Anna" Mai and Administrator Nick Mai over the phone a copy of this report LIC809 and LIC809D and appeal rights were provided at exit.