Senior Care Records.

Facility Evaluation Report

JJ Residential Care IV, INC., Simi Valley06/07/2022Licence 565850086

Capacity4
Census3
Date signed06/13/2022 10:34:46 AM
The inspector’s account

Licensing Program Analyst (LPA) Teresa Camara conducted a case management-deficiencies visit to address deficiencies identified during a complaint investigation regarding complaint number 29-AS-20220607132052. LPA was joined by Tri-Counties Regional Center Quality Assurance Specialists LIz Aced-Arnett and Ryan Landseadel. LPA met with Administrator Lorenzo Banas and explained the reason for the visit.

Staff 1 (S1) was confirmed through interviews with administrator and staff to be a regularly scheduled staff at the facility. S1 has a criminal background clearance but is not associated to the facility.

A $500 immediate civil penalty is assessed today. Pursuant to Title 22, California Code of Regulations, the following deficiencies are cited (refer to LIC 809-D).

Exit interview conducted, civil penalty issued, appeal rights discussed, and a copy of this report issued.

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