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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496801684
Report Date: 12/06/2024
Date Signed: 12/06/2024 02:54:55 PM

Document Has Been Signed on 12/06/2024 02:54 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:AA BEST CARE HOMESFACILITY NUMBER:
496801684
ADMINISTRATOR/
DIRECTOR:
AQUINO, NICANORFACILITY TYPE:
740
ADDRESS:857 HEARN AVE.TELEPHONE:
(707) 546-8413
CITY:SANTA ROSASTATE: CAZIP CODE:
95407
CAPACITY: 40TOTAL ENROLLED CHILDREN: 0CENSUS: 23DATE:
12/06/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:28 PM
MET WITH:Charito Santos (Administrative Assistant)TIME VISIT/
INSPECTION COMPLETED:
03:05 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Cuadra and Frank arrived unannounced for the purpose of conducting a case management to follow up on Administrator certificate and met with Administrative Assistant Charito Santos. Licensee Nick Aquino was not able to come to the facility, but LPA's held a conversation via phone.

On 6/28/23 an informal meeting was conducted in the Santa Rosa Regional Office to address concerns regarding Administrator certification at this facility and the Licensee's other facility, Mc Hugh Care Home 490108000 in which Tiffany Dizon is the identified Administrator. During annual inspection on 7/23/24, LPA issued a citation to the facility due to not having supporting evidence that submitted required documentation received by the Department's certification unit and Licensee agreed to re-submit it timely. On 7/25/24, the facility submitted certified mail tracking number dated 7/25/24 with Sacramento department's address on it to CCL to clear the citation. However, On 12/5/24, LPA have followed up with the Department's certification unit to verify that documentation mailed was received, but they stated that they had staff trying to work with them to resolve their incomplete application for almost an entire year. After multiple notices the certification unit withdrew their application due to failure to comply with Administrator Certification renewal requirements and lack of communication to remediate their application in a timely manner for both facilities.

During today's visit, LPA have a discussion with Licensee via phone regarding this issue and was told that it has been hard to appoint a certified administrator to fill out the administrator position. Per Nick, the hours needed to be completed to have their administrator certificate had been completed and they are in the process to submit required documentation for further processing. However, Licensee agreed to appoint a certified administrator who will spend at least 20 hours in each facility. LPAs will be issuing a citation and Licensee have been informed that if they don't comply with regulations civil penalties will be warrant until this issue gets resolved.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview was conducted with Administrative Assistant and a copy of this report was given.
Bethany MoellersTELEPHONE: (707) 588-5040
Marisol CuadraTELEPHONE: (707) 588-5078
DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2024
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
Document Has Been Signed on 12/06/2024 02:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405


FACILITY NAME: AA BEST CARE HOMES

FACILITY NUMBER: 496801684

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 12/06/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
87405 Administrator - Qualifications and Duties 87405 (a) All facilities shall have a qualified and currently certified administrator. This requirement is not met as evidenced by:
Deficient Practice Statement
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POC Due Date: 12/16/2024
Plan of Correction
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Licensee will appoint a certified administrator for this facility and will submit required documentation to perform this change to the Department by POC due date 12/16/24. Licensee have been informed that if they don't comply with regulations civil penalties will be warrant until this issue gets resolved.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Bethany MoellersTELEPHONE: (707) 588-5040
Marisol CuadraTELEPHONE: (707) 588-5078

DATE: 12/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2024

LIC809 (FAS) - (06/04)
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