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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361880666
Report Date: 07/10/2024
Date Signed: 07/10/2024 11:55:03 AM

Document Has Been Signed on 07/10/2024 11:55 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:DESERT ARCFACILITY NUMBER:
361880666
ADMINISTRATOR/
DIRECTOR:		ANDERSON, DIANNAFACILITY TYPE:
775
ADDRESS:56315 29 PALMS HWYTELEPHONE:
(760) 346-1611
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY: 75CENSUS: 21DATE:
07/10/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Director of Morongo Basin Programs Raymond GosnellTIME VISIT/
INSPECTION COMPLETED:
11:55 AM
NARRATIVE
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On 07/10/2024 at 09:30 AM, Licensing Program Analyst (LPA) Melody Brown met with Director of Morongo Basin Programs Raymond Gosnell to initiate Case Management Visit. The investigation consisted of observation, interviews and a review of pertinent documentation.

During the facility visit on 07/10/2024 at 09:30 AM, LPA Brown reviewed documents and observed that Staff #1 (S1) and Staff#2 (S2) have a current criminal background clearance but S1 and S2 are not currently associated to the facility. Staff interviews and records review indicated S1 had been working at the facility since 12/01/2023 and S2 had been working at the facility since 09/01/2023. LPA Brown informed Director of Morongo Basin Programs Raymond Gosnell that deficiency will be issued. Also, Civil Penalty was assessed with the amount of $500.00 per individual and will continue to be assessed of $100.00 per day per citation until corrected for allowing S1 and S2 to work at the facility and the facility did not transfer S1 and S2's criminal background clearance to the facility. During the facility visit on 07/10/2024, Director of Morongo Basin Programs Gosnell sent an email message to their Personnel Director to transfer S1 and S2 criminal background clearance to the facility.

An exit interview was conducted where this report (LIC809), LIC809D, LIC421BG and Appeal Rights were discussed and provided to Director of Morongo Basin Programs Raymond Gosnell.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2024
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 07/10/2024 11:55 AM - It Cannot Be Edited


Created By: Melody Brown On 07/10/2024 at 11:14 AM
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
, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: DESERT ARC
FACILITY NUMBER: 361880666

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/22/2024
Section Cited
CCR
82065(i)(2)

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82065 Personnel Requirements (i) Prior to employment or initial presence in the day program, all employees and volunteers subject to a criminal...(2) Request a transfer of a criminal record clearance... This requirement is not met as evidenced by:
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Licensee stated to transfer S1 and S2 criminal background clearance to the facility and submit proof to LPA Brown on Plan of Correction (POC) due date.
Licensee stated to submit Signed Statement of Understanding on CCR 82065(i)(2) to LPA Brown on POC due date.
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Based on observation, interview and record review, the Licensee did not comply with the section cited above by not transferring Staff #1 (S1) and Staff #2 (S2) criminal background clearance prior to employment which pose potential health, safety and personal rights risk to clients 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:Efren Malagon
LICENSING EVALUATOR NAME:Melody Brown
LICENSING EVALUATOR SIGNATURE:
DATE: 07/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/10/2024


LIC809 (FAS) - (06/04)
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