Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo, Licensing Program Manager (LPM) Sarah Yip, and Program Clinical Consultant (PCC) Nurse Roxane Fangon conducted a tele-visit via Zoom to provide technical assistance to prevent and mitigate the spread of COVID-19 at the facility and met with Administrator Ariel Palencia.

During visit, LPA Marrufo asked Administrator Ariel Palencia to open the storage room that is near Room 6 in the facility. After opening the door, Administrator Palencia's video feed showed a bed, mattress, and personal items in the storage room. Administrator reported to LPA Marrufo on 10/19/2021 to have received a verbal confirmation from the Fire Marshall that the storage room was not permitted to be used as a bedroom. During today's visit, Administrator Palencia and S1 stated S1 uses the bed in the bedroom during work breaks.

The facility had previously been issued a deficiency citation for using the storage room as a bedroom on 07/22/2021. A second citation along with a $250 civil penalty was issued on 08/03/2021 for having a bed in the storage room.

A deficiency was cited as per California Code of Regulations Title 22. See 809-D for more information.

A repeat civil penalty of $1000 was assessed for a repeated violation within a 12 month period. See LIC421M. If the deficiency is not corrected within 24 hours, an additional $100 per day will be assessed until the deficiency is corrected.

This report was reviewed with Administrator Ariel Palencia and a copy of the report and appeal rights will be sent to him to sign and return to CCL.