Senior Care Records.

Facility Evaluation Report

Agape Collins' Carehome, Vallejo04/05/2024Licence 486804116

Capacity6
Census6
Date signed04/09/2024 11:55:09 AM
The inspector’s account

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced and met with Samantha Ephraim, Licensee . During a complaint investigation LPA discovered staff (S1) who was fingerprinted earlier in the day and had not yet obtained a clearance to this facility as required.

LPA and licensee went over info to change the Administrator and LPA will email info.

LPA also went over staff training and how to document it properly.

A civil penalty was assessed for $100.00 for staff S1 not having a fingerprint clearance to this facility.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.

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