Facility Evaluation Report

Licensing Program Analyst (LPA) Michelle Echeverria arrived at the facility unannounced to conduct a Case Management Visit for health and safety in response to a Special Incident Report (SIR) submitted to the Community Care Licensing Office. LPA arrived and phone called Administrator, Magdalena Ramirez after knocking and ringing door bell three times. Administrator stated that she was on her way and would arrive shortly. LPA was then greeted by Administrator, Magdalena Ramirez. LPA introduced self and stated purpose of the visit.

During today's visit, LPA conducted observations, interviews with relevant parties, obtained and reviewed facility records, and did a walk-through of the facility. LPA found the following issues:

Staff 6 (S6) did not have first aid/cpr certification and worked alone with the clients during their shifts.

Staff 1 (S1) did not have criminal background clearance transfer to this facility by not being associated through Guardian.

Staff 1,3 & 4 (S1, S3 & S4) personnel records were incomplete.

S1 did not have the knowledge and ability to comply with applicable law and regulation.

These pose an immediate and potential health and safety risk to clients in care. Refer to LIC 809D, LIC421BG for deficiencies and civil penalty cited.

An exit interview was conducted where this report, LIC809D, LIC421BG and appeal rights were discussed with and provided to staff, Chandra Howard since Administrator left the facility.