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 Executive Director Scottie Geno.

While conducting file review of staff records, LPA noted that one (1) staff member was not included on the facility's association roster. The staff member (identified as S1) had an eligible background clearance with a previously conducted background check, however their clearance were not transferred over to this facility. Per staff interviews, S1 had been working at the facility for about 1-2 years. S1 was able to be associated to the facility during the visit.

One type A Deficiency is being cited per California Code of Regulations, Title 22, Division 6 on the attached LIC 809-D for the one (1) staff member working without having their clearance associated to the facility. Due to being a violation pertaining to criminal records clearances, a Civil Penalty is being assessed for the total amount of $500.00. Details are noted on the attached LIC 421BG form.

One Deficiency was cited during the visit. An exit interview was conducted with Executive Director Geno 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.