Facility Evaluation Report

Acting Regional Manager – Bethany Moellers, Licensing Program Manager - Kimberley Mota and Licensing Program Analyst – Ethel Contreras met with Licensee/Administrator Josephine Mendoza to address areas of non-compliance.

On June 24, 2025, the Department received a complaint alleging a Personal Rights violation due to a staff hitting a Resident (R1) – Based on the complaint investigation the Department substantiated the allegation Personal Rights. The facility did not report this incident to Community Care Licensing.

The following areas of non-compliance were addressed during the meeting today:

- Facility failed to ensure R1’s personal rights

- Administrator Qualifications and Duties

- Change of condition for residents regarding LIC602 and updating Needs and Service Plans.

In this meeting, it was discussed: R1’s elopement risk, reporting requirement, administrator duties and qualifications. Facility is being cited

Facility is being put on a two-year non-compliance plan. Facility will be referred to Technical Support Program. Resources were provided.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Exit interview conducted. Plan of Corrections reviewed and developed with Licensee/Administrator. Copy of report (LIC809), LIC809-D, and Appeal Rights discussed and provided to Licensee/Administrator. Signature on form confirms receipt of documents.