Facility Evaluation Report

On November 3, 2023, Licensing Program Analyst (LPA) conducted an unannounced visit to follow up on the plan of correction (POC) that was submitted by the administrator/Licensee, Mitzi Murphy. LPA met with the administrator and explained the purpose of today's visit.

During today's visit, LPA observed staff #1 (S1) was assisting the administrator with providing care to resident #1(R1), however, the administrator was not able to provide S1's personnel file and criminal background clearance record to LPA for review as the administrator stated that this staff only worked today and the facility is experiencing staffing shortage. Administrator asked S1 to leave the facility during visit.

A civil penalty of $100 per day x 1 day = $100 is being assessed.

A civil penalty of $250 is being assessed for repeat violation.

Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in additional civil penalties.

Report is reviewed with assistant administrator and a copy is provided with civil penalties and appeal rights.