Facility Evaluation Report

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit to the facility. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Administrator Anitha Sopacua.

As LPA was conducting interviews and file review at the facility, LPA noted that a present staff member, identified as S1, was not included on the facility's association roster. Review of the Guardian background check database revealed S1 did have an eligible background clearance, just that they were not associated to the facility. Per review of S1's staff file, they began work at the facility in April 2025.

One type A Deficiency is being cited per California Code of Regulations, Title 22, Division 6 on the attached LIC 809-D for S1 working at facility without having their clearance associated to the facility. In addition, a Civil Penalty is being assessed for the total amount of $500.00. Details are noted on the attached LIC 421BG form. The facility was able to submit an LIC 9182 request to the regional office to associate S1 during the visit.

One deficiency was cited during the inspection. An exit interview was conducted with Administrator Sopacua to whom a copy of this report, the LIC 421BG, and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.