Facility Evaluation Report

On 09/09/25 Licensing Program Analyst (LPA) Javina George made an unannounced case management deficiencies visit. LPA met with administrator Florence Mojica and observed the following during today's visit:

-LPA observed for the facility to have two (2) live in caregivers. Caregiver #1 (C1) was observed to have fingerprint clearance but was not associated. Caregiver #2 (C2) was observed to not have criminal record clearance. Deficiency cited and civil penalties are being assessed. Please note that C2 began moving out during LPAs visit.

- LPA observed for there to be medication belonging to an unknown individual during today's visit. LPA was informed during an interview conducted with C2 pertaining to complaint control number 18-AS-20250903160204, that the medication belonged to an individual that was deceased. However through additional investigation LPA, was informed that there was a medication that was filled for the same individual on 09/08/25. It was then revealed by C2, that the individual was not deceased, but had required a higher level of care and was dropped off at the hospital in San Bernardino about three (3) months ago. A citation is being issued for false claims.

Further per a file review conducted the governing body was observed to not be in good standing as the FTB is suspended as of May 2025. deficiency cited. Please note that LPA verified and received a copy of the the facility's valid liability insurance.

An exit interview was conducted where a copy of this report, 809D, and appeal rights were reviewed and provided to administrator Florence Mojica.