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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700499
Report Date: 11/21/2024
Date Signed: 11/21/2024 03:20:15 PM

Document Has Been Signed on 11/21/2024 03:20 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ABOUNDING LOVE IIFACILITY NUMBER:
342700499
ADMINISTRATOR/
DIRECTOR:		NONU, JULIEFACILITY TYPE:
740
ADDRESS:3801 LAKE TERRACE DRTELEPHONE:
(916) 547-0206
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 6CENSUS: 5DATE:
11/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Julie NonuTIME VISIT/
INSPECTION COMPLETED:
03:25 PM
NARRATIVE
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Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a case management visit. LPA Moleski met with facility administrator Julie Nonu and explained the purpose of the visit.

This visit is to confirm immediate exclusion orders for a staff member (S1).

Nonu acknowledged that S1 is excluded effective immediately, which means that S1 cannot be allowed to work, live in, and/or have contact with clients in any residential facility licensed by the California Department of Social Services. Therefore, the Department orders this facility to remove S1 from any contact with clients and not allow this employee to be physically present in the facility.

Nonu said that S1 has not been working here for at least two months. Nonu agreed to remove S1 from all facility Guardian rosters as soon as possible.

Additionally, this visit serves also to address a deficiency observed during the course of an unrelated complaint investigation.

During an interview, facility administrator Julie Nonu said that a certain staff member (S2) is responsible for all transportation to medical or other appointments for residents of this facility. This staff member works at multiple other facilities and is currently associated to those facilities. Based on interview with this staff member, S2 has contact with residents of this facility and is alone with these clients during transportation. LPA Moleski reviewed Guardian records and observed that S2 is not associated to this facility.

This facility is hereby cited per 22 CCR Section 87355(e)(2). Due to a violation of criminal record clearance requirements, an immediate civil penalty in the amount of $100 per day worked by S2 for a maximum of five days is hereby assessed. An exit interview was held with Nonu. A copy of this report and the immediate exclusion notice were left with Nonu. Appeal rights were left with Nonu. A signature on this report acknowledges receipt of these documents.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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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Document Has Been Signed on 11/21/2024 03:20 PM - It Cannot Be Edited


Created By: Vincent Moleski On 11/21/2024 at 02:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ABOUNDING LOVE II
FACILITY NUMBER: 342700499

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/22/2024
Section Cited

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“(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: … (2) Request a transfer of a criminal record clearance as specified in Section 87355(c)…” This requirement was not met as evidenced by:
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Based on record review and interview, a staff member and/or employee who has direct contact with residents unsupervised was not associated to this facility’s roster, which poses an immediate health and safety risk.
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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:Stephen Richardson
LICENSING EVALUATOR NAME:Vincent Moleski
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2024


LIC809 (FAS) - (06/04)
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