Facility Evaluation Report

Licensing Program Analyst (LPA) Avelina Martinez arrived at this facility unannounced on 05/16/2024 at 10:58 AM to conduct a case management visit. LPA Martinez met with Casey Kwok at facility and Alex Archangel per telephone call and explained the purpose of the visit.

The purpose of today's visit is to follow up on learned deficiencies during a complaint investigation 27-AS-20240508105753, and to ensure the facility is in compliance with applicable statutes and regulations.

During complaint 27-AS-20240508105753 investigation, it was learned clients were receiving care and supervision and other community services at an unlicensed care facility. As a result, the facility is not following the approved plan of operation that was submitted to the Community Care Licensing Department (CCLD). Any significant changes in the plan of operation which would affect the services to clients shall be submitted to the licensing agency for approval. Therefore, the facility Licensee will need to submit an updated plan of operation to CCLD if clients will return to any G.L.O.M community center or any other day programs. Please submit updated plan of operation to CCLD by June 03, 2024 if any changes are made that will affect client services. CCLD will review the plan of operation for approval once received. As a result, deficiencies have been cited for not following plan of operation. In addition to, administrator qualification due to not conforming to the applicable laws, rules and regulations.

Moreover, during today's visit, LPA Martinez conducted interviews and requested documents. The requested documents are the following: Facility LIC 500 Personnel Report and staff schedules, which were provided during today's visit. Facility staff will email LPA Martinez March, April, and May 2024 payroll/time cards by May 24, 2024 by 5:00 PM. Also, during today's inspection, LPA Martinez observed fair labor law postings in the facility. As a result of this visit, the following deficiencies were cited, per Title 22 Regulations. Deficiencies can be found on the 809-D page. An exit interview was conducted, and a copy of this report, 809D page, and appeals rights were provided to the facility.