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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203375
Report Date: 11/10/2020
Date Signed: 11/10/2020 10:56:50 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:CANDICE HOME CARE IFACILITY NUMBER:
157203375
ADMINISTRATOR:TURALLO, EMMANUELFACILITY TYPE:
740
ADDRESS:5801 COCHRAN DRIVETELEPHONE:
(661) 558-4499
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:6CENSUS: 5DATE:
11/10/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Rodrigo Arrieta, AdministratorTIME COMPLETED:
11:30 AM
NARRATIVE
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On 11/10/2020 at 10:15 am, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a Case Management – Deficiencies inspection. LPA met with Administrator (ADM) Rodrigo Arrieta and advised purpose of inspection. Deficiencies were discussed.

On 10/26/2020, Licensee (LIC) Barbara Zapata provided to LPA an updated LIC500 Personnel Record. Upon review, LPA found S1, S2, S3, and S4 were not associated to the facility and have been working and residing in the facility. S1, S3, and S4 was determined to have fingerprint clearance. S2 did not have fingerprint clearance. On 10/28/2020, LPA confirmed with ADM the following:

S1: Started working on 10/1/2020 and is currently working.

S2: Started working on 10/8/2020 and quit on 10/27/2020.

S3: Started working on 9/25/2020 and is currently working.

S4: Started working on 10/1/2020 and is currently working.

A civil penalty is being assessed in the amount of $100 per day per person, for a maximum of 5 days, for a total of $2000. See LIC421BC for more details.



Deficiencies are being cited based on LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22, see LIC809D.

An exit interview was conducted and Plans of Corrections were reviewed and developed with the Administrator. A copy of this report and appeal rights were discussed and left with Administrator Rodrigo Arrieta, whose signature on this form confirms receipt of these documents.

SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Malia ThaoTELEPHONE: (559) 650-7931
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: CANDICE HOME CARE I
FACILITY NUMBER: 157203375
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/10/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/10/2020
Section Cited

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87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing...in a licensed facility: (1) Obtain a California clearance...as required by the Department or

This requirement is not met as evidenced by:
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On 10/26/2020, LPA received an updated LIC500 from Licensee. Upon review, LPA found S2 did not have fingerprint clearance. This poses an immediate health, safety, and personal rights risk to residents in care.
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Type B
11/10/2020
Section Cited

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87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing...in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c) or
This requirement was not met as evidenced by:
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On 10/26/2020, LPA received an updated LIC500. Upon review, LPA found S1, S3, and S4 were not associated to the facility and had been working and residing in the facility. This poses a potential health, safety, or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Malia ThaoTELEPHONE: (559) 650-7931
LICENSING EVALUATOR SIGNATURE:
DATE: 11/10/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2020
LIC809 (FAS) - (06/04)
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