Senior Care Records.

Facility Evaluation Report

Momentum Work, INC. Rose, Santa Maria04/13/2023Licence 425801987

Capacity4
Census4
Date signed04/13/2023 10:50:00 AM
The inspector’s account

Licensing Program Analyst (LPA) Olson conducted an unannounced Case Management- Incident visit to the facility above. LPA was accompanied by Tri-Counties Regional Center Quality Assurance Specialist (QAS) Vincent Figueroa. LPA and QAS met with Administrator and explained the purpose of the visit.

CCL received an incident report on 04/05/23 stating that on 04/03/23 HR received a letter from a Staff 1 with allegations of staff turning on the vacuum cleaner (noise) to keep Client 1 (C1) in their room. Staff 1 also wrote that staff working with C1 leaves them in dirty soiled pull ups. An addendum was sent on 04/07/23 stating that allegations against staff was substantiated and 2 staff were let go and dismissed. The new Incident report also stated staff will review APS mandated reporting and supervision will be supervised more stringently with unannounced visits from management.

Interview with Administrator revealed all staff will be trained on mandated reporting and personal rights for 2 hours on 4/17/23.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D).

Exit interview conducted, copy of report and appeal rights were printed and emailed.

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