Senior Care Records.

Facility Evaluation Report

Norcal Care Homes, INC., Foster City10/03/2022Licence 419210071

Capacity3
Census3
Date signed10/03/2022 10:17:28 AM
The inspector’s account

On October 3, 2022, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced case management visit to follow-up on a visit that LPA conducted on 7/18/2022 in relation to an incident that occurred on July 14, 2022 and deliver the findings of the Investigation Branch (IB). LPA met with Licensee, Fatollah Glichloo and Administrator, Russlyn Guevarra joined shortly thereafter. LPA explained the purpose of the visit.

On July 15, 2022, the Licensee reported that Staff #1 (S1) found a hidden camera in the common bathroom. In addition, it was indicated that Staff #2 (S2) acknowledged that the camera belonged to him/her. The Department referred this incident to the Investigation Branch.

Based on the investigation that was conducted by the Department and the information collected, S2 admitted to the Licensee that he/she placed a hidden camera in the common bathroom used by one resident and staff. In addition, interviewed staff indicated the hidden camera belonged to S2, because when staff found the camera and removed it from the bathroom, S2 was asking staff where his/her device was.

During the investigation, it was found that the facility staff who found the camera failed to report this incident to the Licensee immediately, resulting in a delay to notify CCLD. According to the Licensee, it was indicated that S1 found the camera on July 10, 2022, however failed to notify the Licensee until the Ombudsman called the Licensee regarding this incident. Although, the Licensee reported this incident to CCLD on 7/15/22, the facility staff failed to report a serious incident to the Licensee immediately.

Deficiency cited today under California Code of Regulations, Title 22, Division 6, Chapter 8 follows on LIC809D. If cited deficiency is not corrected by the due date, a civil penalty may be assessed.

Report is reviewed with Licensee and administrator and a copy is provided

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction