Facility Evaluation Report

On May 18, 2023, at 2:56 p.m., Licensing Program Analyst (LPA) Rayshaun Nickolas visited the facility unannounced. The purpose of this visit is in response to complaint control number 56-AS-20230515152552 received by this agency on May 15, 2023 for another facility that the Licensee owns. LPA met with caregiver Malissa King and explained the purpose of the visit. LPA Nickolas' also discussed this report with Administrator Patricia Woods over the telephone. Woods was not at the facility and gave permission for King to sign this report.

LPA Nickolas’ interviews with multiple witnesses revealed that during a Cinco De Mayo celebration, a resident from another facility grabbed Sunny Delights, and staff #1 (S1) told them, “Put it back it is not yours”. LPA Nickolas interviews revealed that the resident responded, “Don’t talk to me like that, your not my boss”. The witnesses stated that S1 responded, “Who is your boss”, and “Who is this resident’s boss?”. The witnesses stated that the resident ignored S1, and S1 continued by stating that the resident must not like black people. The witnesses stated, eventually, the resident was triggered and went into behavior and called S1 derogatory names.

During LPA Nickolas’ investigation into complaint control number 56-AS-20230515152552, it was discovered that S1 did not work at the facility where the complaint was filed. The resident involved in the incident resided at that facility. Nickolas’ interviews confirmed that S1 did not work at that facility. LPA Nickolas’ file review revealed that S1 is an associated employee with this facility.

Based on interviews conducted and file review, one (1) deficiency was cited per Title 22, Division 6, of the California Code of Regulations (CCR), Sections 80072 (a)(3) Personal Rights .

An exit interview was conducted, where copies of LIC 809, LIC 809D, and due to technical issue a copy of this report will be emailed no later than Friday, May 19, 2023.