392700332-2-18-2021-27-AS-AJON-BYD4CL-20210218175918

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 392700332
Report Date: 02/18/2021
Date Signed: 02/18/2021 06:00:07 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME:	A PLACE CALLED HOME II		FACILITY NUMBER:	392700332
ADMINISTRATOR:	SIMONE A PIERRE JEROME		FACILITY TYPE:	740
ADDRESS:	25820 MAGNOLIA AVE		TELEPHONE:	(209) 986-3949
CITY:	ESCALON	STATE: CA	ZIP CODE:	95320
CAPACITY:	11	CENSUS:	DATE:	02/18/2021
TYPE OF VISIT:	Case Management - Legal/Non-compliance	UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Lesley Pinola		TIME COMPLETED:	06:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Albert Johnson, Regional Manager (RM) Krystall Moore, Licensing Program Managers (LPM) Stephanie Doub, Czarrina Camilon-Lee, and Licensing Program Analyst (LPA) Avelina Martinez conducted an Office Visit via Microsoft Teams with Licensee Lesley Pinola and Attorney Joel Goldman due to COVID-19 and pre-cautionary measures. This meeting was requested to address communication with Lesley and clearing POCs from complaint/audit findings (Title 22 regulations: 87405 (d)(1-7), 87218(a)(1)(2) and HSC 1569.652 ) delivered on 11/06/2020. The citations are outstanding and civil penalties continue to accrue at $100 day. Civil penalties have been accruing since 11/17/2020. The Department conducted an office meeting with Ms. Pinola on 11/6/2020 and 12/7/2020 After the meeting, the reports were sent to Ms. Pinola email address with request to have each reports signed and sent back to LPA Johnson. Ms. Pinola did not return reports with signatures for the 11/06/2020 report nor did she return the report from the 12/07/2020 meeting. At each meeting the plans of correction were discussed and reviewed with Ms. Pinola. Several phone calls were made to Ms. Pinola of which she refused to answer and directed LPA to call her attorney. Continued

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Albert Johnson	TELEPHONE: (916) 217-1390
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: A PLACE CALLED HOME II	FACILITY NUMBER: 392700332
	VISIT DATE: 02/18/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Licensee was notified that the civil penalties for Title 22 regulations: 87405 (d)(1-7), 87218(a)(1)(2) and HSC 1569.652 continue to run and accrue at $100.00 per day, per violation until corrections are made. Licensee was reminded on 12/07/2020 to contact LPA when she had talked with her attorney and these corrections or request for an extension have been made. This did not happen until 2/16/2021, the department was sent a request from Mr. Goldman office requesting a plan of correction that was submitted as such:

"Notwithstanding the foregoing, Ms Pinola hereby submits the following as the Plan of Correction for A Place Called Home II:"

The matter involving payments made by R-1 is currently being investigated by the California Department of Justice. Once this matter has been investigated and adjudicated, A Place Called Home II agrees to promptly pay any and all amounts that it is determined it owes to the estate of R-1.

This request was sent well after the timeline for extensions. The Department will not give an extension for the original plan of correction and will not recognize the new request submitted on 2/16/2021.

Exit interview was conducted during the meeting and RM Moore confirmed that a report would be sent to Ms. Pinola and Mr. Goldman. An electronic copy of the report was emailed to the facility to obtain a signature from the Licensee and emailed back to LPA to be filed.

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Albert Johnson	TELEPHONE: (916) 217-1390
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2