Facility Evaluation Report

Licensing Program Analyst (LPAs) Vincent Moleski and Holly Williams arrived unannounced to open a complaint investigation and observed unrelated deficiencies. LPAs Moleski and Williams spoke with facility administrator Diana Garcia on the telephone and explained the purpose of the visit. Garcia said staff member Misivono Qadroka could sign this report in her absence.

Upon arrival, LPAs Moleski and Williams observed a caregiver present in the facility (S1). LPA Williams reviewed Guardian records and observed S1 was not associated to this facility. S1 told LPA Moleski that they had been working at this facility since 9/1/24, and works five days per week. LPAs Moleski and Williams reviewed S1's file and observed that it was not complete. S1's personnel record (LIC 501) was not completed, did not include S1's educational history or past work experience, and was not signed by S1.

This facility is hereby cited per 22 CCR Sections 87355(e)(2) and 87412(a). An exit interview was held with Garcia. Appeal rights and a copy of this report were left with Qadroka.