Facility Evaluation Report

Licensing Program Analyst Alviso arrived unannounced to conduct an Annual Required inspection and met with caregiver, Tina Rundle. LPA contacted the Licensee/Administrator Darian Hall; Darian Hall couldn't make it to the facility. Darcy Harlan arrived to the facility to meet with the LPA. Darian Hall, Licensee, arrived to the facility to meet with the LPA.

Darian Hall stated that Darcy Harlan is the Administrator because they/Darian can no longer be the Administrator. Darcy Harlan has a current Adult Residential Administrator certificate #702498735 -expires 3/18/25.

LPA is requesting the Administrator change documents to appoint Darcy Harlan as the facility Administrator. Include the following documentation: As discussed, cover letter requesting a change of Administrator, include effective date, address and contact information. Copy of administrator certificate, and an LIC308 Designation of facility responsibility. Submit an updated LIC500 personnel report of all staff, days and hours on duty.

Per LPA's record reviews, two (2) staff S1 & S2, are not associated to the facility as required. This deficiency will be cited, Criminal Record Clearance 80019(e)(3)(4) -All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 80019(f) or Request and be approved for a transfer of a criminal record exemption, as specified in Section 80019.1(r), unless, upon request for the transfer, the Department permits the individual to be employed, reside or be present at the facility, see LIC809.

The following deficiency was observed 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.