Facility Evaluation Report

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a case management visit regarding a deficiency LPA observed. LPA met with staff and explained the purpose of the visit.

The purpose of the phone call was regarding LPA and Licensee's phone conversation on October 6, 2025 when Licensee stated a new administrator has started at the facility, which LPA informed Licensee that a fingerprint transfer was needed prior to new administrator working at the facility.

Today's visit, LPA conducted an audit via Guardian and confirmed that S1 has not been associated to the facility. LPA met with S1 and informed S1 that Licensee is to submit a written notice of appointing a new administrator along with the copy of the Administrator Certificate within 30 days of employment.

Additionally, LPA and new Administrator discussed if facility needs to transfer a criminal record clearance to the facility roster, they are to submit a copy of LIC 9182 along with a copy of individual's identification card and/or driver's license to sacasctransferrequest@dss.ca.gov

New Administrator completed LIC 9182 to transfer S1's criminal record clearance to the facility. LPA completed the transfer on Guardian. LPA provi ded new Administrator a copy of LIC 9182 and CCR 87355 Criminal Record Clearance . As a result of today's visit, deficiencies cited. Please see LIC 809-D.

Exit interview and a copy of report and appeal rights provided.