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13Q. Criminal Clearance Copy
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Question 1 of 4
1. Question
1 point(s)Category: DeficienciesTrue or False:
A staff member who did not have a current criminal background clearance was present at the time of the visit and observed working as cleaning staff in the facility.CorrectIncorrectHint
During a visit conducted today, LPA discovered, through interviews and personal observation, that one staff, identified as Staff 1 (S1) [Licensee was 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.
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Question 2 of 4
2. Question
1 point(s)Category: DeficienciesFor this deficiency, a civil penalty in the amount of ______ was assessed.
CorrectIncorrectHint
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.
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Question 3 of 4
3. Question
1 point(s)Category: DeficienciesMatch this deficiency with the proper Plan of Correction.
(Mark all that are correct)All individuals subject to a criminal record review shall obtain a California clearance or a criminal record exemption as required by the Department. This requirement 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.
CorrectIncorrectHint
Deficiency Type /
Section NumberDEFICIENCIES PLAN OF CORRECTIONS (POCs) Type A
09/20/2018
Section Cited
CCR
87355(e)(1)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.** -
Question 4 of 4
4. Question
1 point(s)Category: DeficienciesTrue or False:
A copy of the report and Licensee/Appeal Rights were provided to the licensee at the exit interview.CorrectIncorrectHint
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.
