Facility Evaluation Report

LPA Jeung met with staff and toured facility. There are 7 bedrooms, 5 of which are occupied as private rooms. There is a room above the garage with 3 beds for overnight caregivers. There are 2 caregivers on-site today. One does not have criminal record clearance.

Based on information previously provided to CCLD, a former staff person worked at facility without criminal record clearance. This information was verified by administrator Ermitano. LPA reviewed staff file.

Based on this information, deficiencies of the CA Code of Regulations, Title 22 are cited on a following page, and civil penalties are assessed:

- Staff #1 has worked at facility for 2 days without criminal record clearance= $100/day x 2 days

- Staff #2 worked at facility from 9/2021 - 6/2022 without criminal record clearance=$100/day x 5 days max.