Complaint Investigation Report

496801807-12-15-2022-21-AS-KMOA-CMCQJL-20221222111256

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

10/25/2022 and conducted by Evaluator Erik Gonzalez Campos

COMPLAINT CONTROL NUMBER: 21-AS-20221025101410

Staff not fingerprint cleared and/or associated.

Licensing Program Analyst (LPA) Erik Gonzalez Campos arrived unannounced on 12/15/2022 to deliver complaint findings regarding the allegation above. Administrator, Angelica Martinez was not available but was notified of findings over the phone and agreed to have staff sign complaint report.

LPA investigated the allegation that staff were not fingerprint cleared and/or associated. During the initial inspection on 11/03/2022 LPA reviewed staff records, personnel reports, staff sign in sheets, and Guardian roster. Record review revealed that Staff 1 (S1) was fingerprint cleared and associated to licensee’s other facility but not Yerba Buena Residential Care Home. S1 has since been associated to the facility. The preponderance of evidence standard has been met; therefore, the above allegation is substantiated.

No deficiencies cited. LPA has assessed a technical violation regarding criminal record clearance transfers. Exit interview conducted with staff, Marbella Matus. Report emailed to administrator.