Facility Evaluation Report

A virtual informal office meeting was conducted today with CCL ASCP Regional Offices including Sacramento South, Sacramento North and Fresno via Microsoft Teams.

Present at the meeting were Regional Managers (RM) Brenda White and Alycia Berryman, Licensing Program Managers See Moua, Liza King, Sergiy Pidgimy and Maribeth Senty, Licensing Program Analysts Maja Jensen, Kerry Hiratsku, Mary Garza and Lady Cabrera, Supervising Auditor Jacqueline Juarez and Auditor Diana Chapman.

Licensee Representative for Everwell Facilities included: Dr. Christopher Zubiate, Madison Fetyko and Tina Perez

This meeting is a result of the solvency audit stemming from a complaint(s) received.

During investigation of Complaint Number 27-AS-20210123161803, interview of the payee provider and Administrator verified that the forms requested by the payee service were not being submitted to the payee, instead documentation that did not include the description and amount spent or withdrawn were submitted. Licensee is not providing adequate documentation to the third-party payee and financial representative for some of the clients.

Per California Code of Regulations, Title 22 Division 6, Chapter 8, deficiencies are being cited on the attached

809D during this visit. Exit interview held, Appeal Rights discussed, Copy of report given.