13. Unannounced Visit: Criminal Clearance Copy

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Facility Type: 740 (RCFE)

Investigation Findings
Licensing Program Analyst (LPA) conducted a case management visit to cite for a deficiency that was observed during a complaint investigation visit. LPA met with Licensee and discussed the purpose of the visit.

During a visit conducted today, LPA discovered through interviews and personal observation that one staff, identified as Staff 1 (S1) [Licensee provided an LIC 811 Confidential Names List which identifies the staff], who was present at the time of the visit and observed working as cleaning staff in the facility, did not have a current criminal background clearance.

Deficiency is being cited Per Title 22, Division 6, Chapter 8 of the California Code of Regulations and is listed on LIC 9099-D. An exit interview was conducted, and this report was discussed with Licensee. A copy of the report and Licensee/Appeal Rights (LIC 9058 01/16) were provided to the licensee, and her signature on this form acknowledges receipt of the rights and report.

Deficiency Type /
Section Number
Type A
Section Cited
Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Sec 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Dept.
This req't is not met as evidenced by: Based upon LPA's observation, S1 was working in the facility with no proof of current criminal background clearance. This poses an immediate safety risk to residents in care. A civil penalty in the amount of $500 was assessed.
Licensee requested that S1 leave the facility during the visit. Licensee provided proof that S1 had Live Scan fingerprinting done on 9/18/2018 and stated that S1 will not be permitted to return until the criminal record clearance has been obtained.
**This is an amended version of the original report created on 9/19/2018.**


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