Facility Evaluation Report

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Caregiver. Caregiver (S1) arrived later. Licensee and Administrator of record, Nicholas Humphrey was out of town and not available. LPA reached Licensee by phone. At conclusion of inspection per S1, caregiver has permission/authority to sign CCL report. S1 was present via telephone for exit interview.

LPA has been working with Licensee since December 12, 2023, with on going correspondence both via email and telephone, to change facility Administrator to S1. S1 has been acting as both caregiver and Administrator. S1 works NOC shift and per submitted LIC500 for Admin change, S1 was identified to work M-Th 10pm-6am and Friday 8am-5pm. LPA advised Admin of CCL's concern of how S1 would be able to fulfill the specified Administrator duties per Title 22 regulation 87405 working one day per week during business hours. Per email communication on 3/29/2024 from Licensee to CCL, they have chosen a different Admin candidate other than S1, so that S1 will remain the NOC shift employee. Licensee advised CCL that they would be sending a new LIC500 to reflect the changes and new Admin. Licensee is also that current Administrator of record, however their Admin certificate is neither active nor pending. Per Title 22 regulation 87405 Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator ( deficiency cited, see 809D ).

Upon LPA arrival at facility today, Licensee advised LPA via telephone that now they have sold the home and closed escrow as of this week (week of 4/1/2024) and they intend to complete a change of ownership for the facility. LPA advised Licensee that until the applicant that has applied with CCL is approved and licensed as the current licensee and approved as Administrator they will continue:

as the licensee and Admin of the facility

to be responsible for the operation of the facility and plan of operation

to be responsible for the staffing of all caregivers and staff, including all staff training, resident care, and all maintenance of the facility will continue under their name