Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced case management visit for the purpose of conducting a health and safety inspection. LPA was greeted and granted entry by Staff Joey Sarmiento. LPA met with Staff Yumi Lumuthang and the purpose of the inspection was discussed.

During today’s inspection, residents were observed resting in their respective bedrooms. LPA conducted a tour of the facility and observed utilities, including water, gas, and electricity to be operational. LPA observed there is uneven flooring in room 3, posing a tripping hazard. LPA observed a two-day supply of perishable and a seven-day supply of non-perishable foods. During their interview, two of two staff stated they were paid late and incomplete wages for the last pay period and stated they were unsure when they would be paid in full. Per two of two staff, utilities have been and continue to be operational, and food supply is and has been maintained at a two-day supply perishable and seven-day supply non-perishable.

Deficiency cited under Health and Safety Code 1569.605 pertaining to Liability Insurance has not been cleared, as Licensee did not comply with POC. CIVIL PENALTY IS BEING ASSESSED.

Deficiency cited under Title 22 Regulation 87213 pertaining to Finances has not been cleared as Licensee did not comply with the POC. CIVIL PENALTY IS BEING ASSESSED.

Deficiency cited under 87211(d)(4) pertaining to Reporting Requirements has not been cleared as Licensee did not comply with the POC. CIVIL PENALTY IS BEING ASSESSED.

Based on observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Civil penalties are also being assessed, see LIC421FC. An exit interview was conducted, and a copy of this report and appeal rights was provided at the end of the inspection.