Gran Jurado del Condado de Riverside
2003-2004
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Hallazgos & Recomendaciones
13 hallazgos
F1:
During the period January through May 2004, Riverside County officials received approximately 100 citizens’ complaints regarding the Indio Shelter concerning the treatment of animals and the negative attitude of employees toward the public and rescue organization representatives.
Recomendaciones relacionadas (1)
R1:
Riverside County Animal Control Department develop and revise kennel operating policies and procedures that specifically apply to the Indio Shelter addressing the following areas: a. Field Service responsibilities and practices. b. Administrative and Office Record System. c. Vehicle maintenance and operation. d. Care of injured and/or sick animals. e. Euthanasia.
F2:
Only 22 of the 2,720 animals impounded in FY 2002-2003 at the Indio Animal Control Shelter were transported to a veterinarian for treatment of their injuries or illness. 2
Recomendaciones relacionadas (1)
R2:
The Indio Animal Control Management install shelves in the metal shed to store administrative records that are currently on the floor in the metal storage shed and in a bathroom.
F3:
The disposition of impounded animals from the Indio Animal Control Shelter representing seven (7) months in the FY 2003- 2004 are reflected below: DISPOSITION OF IMPOUNDED ANIMALS Held over FY 2003-2004 And Impounded FY 2002-2003 (7/1/03 – 2/29/04) FY 2001-2002 2,720 1,731 Euthanasia 1,879 69.1% 1,152 66.5% Adopted 477 17.5% 244 14.1% Return to Owner 364 13.4% 335 19.4% *Note: Fiscal Year starts July 1st through June 30th.
Recomendaciones relacionadas (1)
R3:
Management at the Indio Animal Shelter provide soft foods for young, elderly and/or sick animals and store all animal food properly in the food storage locker.
F4:
According to current policy dogs are held (5) days post-impound before the public or rescue organizations can adopt.
Recomendaciones relacionadas (1)
R4:
Indio Animal Control Services Supervisor establish an effective work schedule that focuses on managing the operations at the Indio facility.
F5:
Currently, the Indio Animal Control Shelter has working relationships with only the following three (3) rescue organizations and a private citizen: • Save-a-Pet • Yucaipa Animal Placement Service • Orphan Pet Oasis • Private Citizen
Recomendaciones relacionadas (1)
R5:
Replace all missing drain covers to prevent injury to small dogs.
F6:
Evidence shows that the Director of Riverside County Animal Control Services Department rarely visited the Indio Animal Control Shelter and was not well informed regarding the operations of the Indio Animal Shelter.
Recomendaciones relacionadas (1)
R6:
Formal disciplinary action be taken against employees who fail to take injured, sick or suffering animals to the veterinarian or abuse or neglect impounded animals.
F7:
The management for the Animal Control Shelter in Indio failed to utilize an independent and unbiased citizen complaint process to address the public’s issues and concerns.
Recomendaciones relacionadas (1)
R7:
Indio Animal Control Service Supervisor and staff attend appropriate training classes that emphasize public relations and effective communications with rescue organizations. 6
F8:
During a visit at the Indio Animal Control Shelter, the Grand Jury observed the following conditions: a. Most of the 30 dog kennels were dirty with strong unpleasant odor of feces and/or vomit on the floor. (Photographs 1 and 2). 3 b. Soft canned food for very young, elderly or sick animals was unavailable. c. Towels, blanket or paper to create a more comfortable environment for puppies, kittens, and older or sick animals was unavailable. d. Upper fencing on some kennels that would prevent larger dogs from jumping into another kennel was missing. (Photograph 3) e. Drain holes (6-8” in diameter) in the kennel floors were uncovered. (Photographs 4 and 5) f. Freezer containing euthanized animals was unlocked and accessible to anyone on the property. g. An outdoor run for overflow had no protective covering to reduce exposure from the sun. h. The condition of the building showed a need for repairs and has not been repainted since 1974. i. Cooling misters that surround the outside animal quarantine area were inoperative. j. Administrative and animal records were observed to be scattered on the floor and spilling out of file boxes in a metal shed that also contained bags of dog and cat food. (Photograph 6) k. Two (2) of the animal control vehicles do not have the circulating roof swamp coolers on them. l. Upon reviewing the Riverside County Policy and Procedure Manual there are no procedures for implementation of spay/neuter programs. 4
Recomendaciones relacionadas (1)
R8:
Create a schedule of operating hours (staying within budget) at the Indio Animal Shelter to accommodate the working public for increased access to reclaim lost pets and promote adoptions.
F9:
Prior to the euthanasia of animals, the Indio Kennel Attendants do not obtain the name and phone number of private citizens and rescue organizations who have placed a “Hold” on an animal for adoption and therefore, are not in compliance with the Indio Animal Shelter’s Policy Number 326. This policy states, “If there are any holds on an animal (even if they are expired), an attempt will be made, via phone to the person or persons to confirm they are not interested in the animal.”
Recomendaciones relacionadas (1)
R9:
Develop an effective program to increase pet adoptions, returning lost pets back to their owners, reduce euthanasia by: (cid:131) Implementation of an aggressive spay/neuter program. (cid:131) Distribute educational materials to the public regarding pet adoption and the need for spay/neuter. (cid:131) Aggressive networking with rescues organizations that could incorporate offsite adoptions. (cid:131) Maintain and update “website” to promote adoptions.
F10:
Many animals impounded at the Indio Animal Shelter are not receiving needed veterinary care. This practice is in violation of California Civil Code Section 1834.4(a) and (b) which states, “impounded animals must receive appropriate veterinary care” and also violates Section 559d (a) and (b) of the California Penal Code, which require that “no adoptable or treatable animal be killed”.
Recomendaciones relacionadas (1)
R10:
Indio Animal Control Shelter establish contracts and expand working relationships with rescue organizations to increase the number of pet adoptions.
F11:
In accordance with Riverside County Animal Service Policy Number 335, all animals deemed suitable for adoption are administered Bordatella vaccination as well as the 5 in 1 injection. Although this information is recorded on the Animal Cage Card, the rescue organization’s representatives and private citizens are not notified of the vaccinations when adopting the animals.
Recomendaciones relacionadas (1)
R11:
The Director of Animal Control provide a staff member, with experience in public relations, to serve as the Indio Animal Service Liaison to establish coordination with rescue organizations and pet adoptions.
F12:
The Supervising Animal Control Officer at the Indio Animal Shelter was unable to provide documentation or clearly articulate the qualifications, behavioral standards, problem solving skills and human relations skills for the Animal Control Officers Position.
Recomendaciones relacionadas (1)
R12:
In FY 2004-2005 the Indio Animal Shelter establish and promote a pet adoption program with the goal to reduce by at least twenty-five percent (25%) the number of animals euthanized.
F13:
In April 2003, a person present at the Indio Animal Shelter, documented the following acts of cruelty to animals: a. “Kennel attendants kicking and punching dogs like they were punching bags that were in the process of being euthanized. b. Newborn kittens (a week old) were not fed and were allowed to starve to death. c. Kennel attendants using their animal control sticks to drag cats to the edge of the cage for the purpose of euthanasia. 5 d. Kennel attendants hitting cats with their animal control stick to calm them prior to moving to another cage or euthanasia.”
Recomendaciones relacionadas (1)
R13:
Revise the current complaint process through implementing a three-part (3) Citizen’s Animal Service Complaint Form with a tracking number and copies furnished to:
Recomendaciones adicionales
1
No vinculadas a hallazgos específicos.
R14:
The Director of Community Health Agency submit a quarterly report to the Board of Supervisors, which includes a copy of the complaint and corrective action taken. 7
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Hallazgos & Recomendaciones
13 hallazgos
F1:
During the period January through May 2004, Riverside County officials received approximately 100 citizens’ complaints regarding the Indio Shelter concerning the treatment of animals and the negative attitude of employees toward the public and rescue organization representatives.
Recomendaciones relacionadas (1)
R1:
Riverside County Animal Control Department develop and revise kennel operating policies and procedures that specifically apply to the Indio Shelter addressing the following areas: a. Field Service responsibilities and practices. b. Administrative and Office Record System. c. Vehicle maintenance and operation. d. Care of injured and/or sick animals. e. Euthanasia.
F2:
Only 22 of the 2,720 animals impounded in FY 2002-2003 at the Indio Animal Control Shelter were transported to a veterinarian for treatment of their injuries or illness. 2
Recomendaciones relacionadas (1)
R2:
The Indio Animal Control Management install shelves in the metal shed to store administrative records that are currently on the floor in the metal storage shed and in a bathroom.
F3:
The disposition of impounded animals from the Indio Animal Control Shelter representing seven (7) months in the FY 2003- 2004 are reflected below: DISPOSITION OF IMPOUNDED ANIMALS Held over FY 2003-2004 And Impounded FY 2002-2003 (7/1/03 – 2/29/04) FY 2001-2002 2,720 1,731 Euthanasia 1,879 69.1% 1,152 66.5% Adopted 477 17.5% 244 14.1% Return to Owner 364 13.4% 335 19.4% *Note: Fiscal Year starts July 1st through June 30th.
Recomendaciones relacionadas (1)
R3:
Management at the Indio Animal Shelter provide soft foods for young, elderly and/or sick animals and store all animal food properly in the food storage locker.
F4:
According to current policy dogs are held (5) days post-impound before the public or rescue organizations can adopt.
Recomendaciones relacionadas (1)
R4:
Indio Animal Control Services Supervisor establish an effective work schedule that focuses on managing the operations at the Indio facility.
F5:
Currently, the Indio Animal Control Shelter has working relationships with only the following three (3) rescue organizations and a private citizen: • Save-a-Pet • Yucaipa Animal Placement Service • Orphan Pet Oasis • Private Citizen
Recomendaciones relacionadas (1)
R5:
Replace all missing drain covers to prevent injury to small dogs.
F6:
Evidence shows that the Director of Riverside County Animal Control Services Department rarely visited the Indio Animal Control Shelter and was not well informed regarding the operations of the Indio Animal Shelter.
Recomendaciones relacionadas (1)
R6:
Formal disciplinary action be taken against employees who fail to take injured, sick or suffering animals to the veterinarian or abuse or neglect impounded animals.
F7:
The management for the Animal Control Shelter in Indio failed to utilize an independent and unbiased citizen complaint process to address the public’s issues and concerns.
Recomendaciones relacionadas (1)
R7:
Indio Animal Control Service Supervisor and staff attend appropriate training classes that emphasize public relations and effective communications with rescue organizations. 6
F8:
During a visit at the Indio Animal Control Shelter, the Grand Jury observed the following conditions: a. Most of the 30 dog kennels were dirty with strong unpleasant odor of feces and/or vomit on the floor. (Photographs 1 and 2). 3 b. Soft canned food for very young, elderly or sick animals was unavailable. c. Towels, blanket or paper to create a more comfortable environment for puppies, kittens, and older or sick animals was unavailable. d. Upper fencing on some kennels that would prevent larger dogs from jumping into another kennel was missing. (Photograph 3) e. Drain holes (6-8” in diameter) in the kennel floors were uncovered. (Photographs 4 and 5) f. Freezer containing euthanized animals was unlocked and accessible to anyone on the property. g. An outdoor run for overflow had no protective covering to reduce exposure from the sun. h. The condition of the building showed a need for repairs and has not been repainted since 1974. i. Cooling misters that surround the outside animal quarantine area were inoperative. j. Administrative and animal records were observed to be scattered on the floor and spilling out of file boxes in a metal shed that also contained bags of dog and cat food. (Photograph 6) k. Two (2) of the animal control vehicles do not have the circulating roof swamp coolers on them. l. Upon reviewing the Riverside County Policy and Procedure Manual there are no procedures for implementation of spay/neuter programs. 4
Recomendaciones relacionadas (1)
R8:
Create a schedule of operating hours (staying within budget) at the Indio Animal Shelter to accommodate the working public for increased access to reclaim lost pets and promote adoptions.
F9:
Prior to the euthanasia of animals, the Indio Kennel Attendants do not obtain the name and phone number of private citizens and rescue organizations who have placed a “Hold” on an animal for adoption and therefore, are not in compliance with the Indio Animal Shelter’s Policy Number 326. This policy states, “If there are any holds on an animal (even if they are expired), an attempt will be made, via phone to the person or persons to confirm they are not interested in the animal.”
Recomendaciones relacionadas (1)
R9:
Develop an effective program to increase pet adoptions, returning lost pets back to their owners, reduce euthanasia by: (cid:131) Implementation of an aggressive spay/neuter program. (cid:131) Distribute educational materials to the public regarding pet adoption and the need for spay/neuter. (cid:131) Aggressive networking with rescues organizations that could incorporate offsite adoptions. (cid:131) Maintain and update “website” to promote adoptions.
F10:
Many animals impounded at the Indio Animal Shelter are not receiving needed veterinary care. This practice is in violation of California Civil Code Section 1834.4(a) and (b) which states, “impounded animals must receive appropriate veterinary care” and also violates Section 559d (a) and (b) of the California Penal Code, which require that “no adoptable or treatable animal be killed”.
Recomendaciones relacionadas (1)
R10:
Indio Animal Control Shelter establish contracts and expand working relationships with rescue organizations to increase the number of pet adoptions.
F11:
In accordance with Riverside County Animal Service Policy Number 335, all animals deemed suitable for adoption are administered Bordatella vaccination as well as the 5 in 1 injection. Although this information is recorded on the Animal Cage Card, the rescue organization’s representatives and private citizens are not notified of the vaccinations when adopting the animals.
Recomendaciones relacionadas (1)
R11:
The Director of Animal Control provide a staff member, with experience in public relations, to serve as the Indio Animal Service Liaison to establish coordination with rescue organizations and pet adoptions.
F12:
The Supervising Animal Control Officer at the Indio Animal Shelter was unable to provide documentation or clearly articulate the qualifications, behavioral standards, problem solving skills and human relations skills for the Animal Control Officers Position.
Recomendaciones relacionadas (1)
R12:
In FY 2004-2005 the Indio Animal Shelter establish and promote a pet adoption program with the goal to reduce by at least twenty-five percent (25%) the number of animals euthanized.
F13:
In April 2003, a person present at the Indio Animal Shelter, documented the following acts of cruelty to animals: a. “Kennel attendants kicking and punching dogs like they were punching bags that were in the process of being euthanized. b. Newborn kittens (a week old) were not fed and were allowed to starve to death. c. Kennel attendants using their animal control sticks to drag cats to the edge of the cage for the purpose of euthanasia. 5 d. Kennel attendants hitting cats with their animal control stick to calm them prior to moving to another cage or euthanasia.”
Recomendaciones relacionadas (1)
R13:
Revise the current complaint process through implementing a three-part (3) Citizen’s Animal Service Complaint Form with a tracking number and copies furnished to:
Recomendaciones adicionales
1
No vinculadas a hallazgos específicos.
R14:
The Director of Community Health Agency submit a quarterly report to the Board of Supervisors, which includes a copy of the complaint and corrective action taken. 7
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Hallazgos & Recomendaciones
10 hallazgos
F1:
Blythe CPS Office does not have reasonable access to community services and county support systems that are required to implement the vision and missions of the Children’s Service Division. Although money has been appropriated in the budget, the following services and support systems are not available in the Blythe Community: (cid:131) Foster Care Facility (cid:131) Temporary Shelter (cid:131) Sufficient number of staff (cid:131) Necessary Mental Health Department Support
Recomendaciones relacionadas (1)
R1:
Department of Social Services immediately hire or reassign the required number of social workers, as budgeted, in Blythe to adequately support the mission of Children’s Service Division.
F2:
The CPS, Blythe Office, does not have security-warning devices installed nor does it utilize an on-site security officer to provide protection for the staff. In more than one instance, angry parents or family members have threatened social workers.
Recomendaciones relacionadas (1)
R2:
Establish a temporary public shelter or contract with a local provider to provide temporary shelter of placement children who are removed from their homes during late evening or early morning hours.
F3:
Children who are removed from their home during late evening or early morning hours due to neglect or abuse are held in the CPS Office due to the unavailability of temporary shelters or Foster Care Facilities. A staff member must remain awake to ensure the child’s safety and well-being.
Recomendaciones relacionadas (1)
R3:
Establish new Foster Care provider contracts and/or reactivate contracts with former Foster Care providers for child placement, with the approval of Community Care Licensing.
F4:
In Blythe there are no temporary shelters or Foster Care Facilities for child placement. Children who are removed from a home in Blythe, are transported by CPS staff members to Indio or more distance locations within Riverside County; i.e. Moreno Valley, Corona and Riverside. These trips can take up to 6-8 hours.
Recomendaciones relacionadas (1)
R4:
Repair, update and maintain the teleconferencing system in the Blythe CPS Office to reduce the number of trips for staff training.
F5:
Blythe CPS staff, which transport children (mid-day to late evening) to cities in Western Riverside County, are expected to work their normal work schedule the following day without sufficient rest. 3
Recomendaciones relacionadas (1)
R5:
Riverside County Fleet Service Department elevate vehicle maintenance standards for county vehicles used by the Blythe Children’s Service staff members to ensure reliable mechanical operations and maximum safety.
F6:
In 2003, Blythe CPS staff recorded 228 trips out of Blythe. Approximately seventy percent (70%) of these trips were made to seven (7) cities in Riverside County including Indio (85), Moreno Valley (17), Corona (12), Cathedral City (12), Desert Hot Springs (11), Rancho Mirage (10), and Riverside (11). The purpose of the trips were for: (cid:131) Family Visits (cid:131) Child Placement (cid:131) Court Appearances (cid:131) Staff Training
Recomendaciones relacionadas (1)
R6:
The Department of Mental Health develop and implement a tracking system in Blythe to monitor the effectiveness of the Substance Abuse and other Mental Health counseling services provided to family members.
F7:
Children, who are removed from their home in Blythe due to neglect or abuse, linger in the Foster Care System while their parents enter Department of Mental Health programs for counseling to become more responsible parents, as required by the courts.
Recomendaciones relacionadas (1)
R7:
Install security devices (panic buttons, alarms, interface barriers between staff and public) to alert the staff and law enforcement of possible danger and provide protection for the clerical staff.
F8:
Blythe CPS staff were using vehicles later to be found defective to transport children to placement locations in Riverside County. On two (2) separate occasions while transporting children and family members CPS staff experienced major mechanical problems, including brake malfunction and parts falling off the vehicle.
Recomendaciones relacionadas (1)
R8:
The Department of Mental Health in Blythe, provide the court required Substance Abuse counseling and other needed Mental Health Services for family members prior to returning the child to their home. Report Issued: 06/23/04 Report Public: 06/25/04 Response Due: 09/21/04 5
F9:
Blythe CPS teleconferencing system, which is utilized for training and would reduce traveling to Indio, has been inoperative for approximately two years.
F10:
The Blythe CPS Office budgeted position and actual staffing are shown in the chart below: Positions Title Budgeted Actual Social Worker 5 3 Office Assistant 1 1 Receptionist 1 0 Social Service Assistant 1 1 Total 8 5 4
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Hallazgos & Recomendaciones
10 hallazgos
F1:
Blythe CPS Office does not have reasonable access to community services and county support systems that are required to implement the vision and missions of the Children’s Service Division. Although money has been appropriated in the budget, the following services and support systems are not available in the Blythe Community: (cid:131) Foster Care Facility (cid:131) Temporary Shelter (cid:131) Sufficient number of staff (cid:131) Necessary Mental Health Department Support
Recomendaciones relacionadas (1)
R1:
Department of Social Services immediately hire or reassign the required number of social workers, as budgeted, in Blythe to adequately support the mission of Children’s Service Division.
F2:
The CPS, Blythe Office, does not have security-warning devices installed nor does it utilize an on-site security officer to provide protection for the staff. In more than one instance, angry parents or family members have threatened social workers.
Recomendaciones relacionadas (1)
R2:
Establish a temporary public shelter or contract with a local provider to provide temporary shelter of placement children who are removed from their homes during late evening or early morning hours.
F3:
Children who are removed from their home during late evening or early morning hours due to neglect or abuse are held in the CPS Office due to the unavailability of temporary shelters or Foster Care Facilities. A staff member must remain awake to ensure the child’s safety and well-being.
Recomendaciones relacionadas (1)
R3:
Establish new Foster Care provider contracts and/or reactivate contracts with former Foster Care providers for child placement, with the approval of Community Care Licensing.
F4:
In Blythe there are no temporary shelters or Foster Care Facilities for child placement. Children who are removed from a home in Blythe, are transported by CPS staff members to Indio or more distance locations within Riverside County; i.e. Moreno Valley, Corona and Riverside. These trips can take up to 6-8 hours.
Recomendaciones relacionadas (1)
R4:
Repair, update and maintain the teleconferencing system in the Blythe CPS Office to reduce the number of trips for staff training.
F5:
Blythe CPS staff, which transport children (mid-day to late evening) to cities in Western Riverside County, are expected to work their normal work schedule the following day without sufficient rest. 3
Recomendaciones relacionadas (1)
R5:
Riverside County Fleet Service Department elevate vehicle maintenance standards for county vehicles used by the Blythe Children’s Service staff members to ensure reliable mechanical operations and maximum safety.
F6:
In 2003, Blythe CPS staff recorded 228 trips out of Blythe. Approximately seventy percent (70%) of these trips were made to seven (7) cities in Riverside County including Indio (85), Moreno Valley (17), Corona (12), Cathedral City (12), Desert Hot Springs (11), Rancho Mirage (10), and Riverside (11). The purpose of the trips were for: (cid:131) Family Visits (cid:131) Child Placement (cid:131) Court Appearances (cid:131) Staff Training
Recomendaciones relacionadas (1)
R6:
The Department of Mental Health develop and implement a tracking system in Blythe to monitor the effectiveness of the Substance Abuse and other Mental Health counseling services provided to family members.
F7:
Children, who are removed from their home in Blythe due to neglect or abuse, linger in the Foster Care System while their parents enter Department of Mental Health programs for counseling to become more responsible parents, as required by the courts.
Recomendaciones relacionadas (1)
R7:
Install security devices (panic buttons, alarms, interface barriers between staff and public) to alert the staff and law enforcement of possible danger and provide protection for the clerical staff.
F8:
Blythe CPS staff were using vehicles later to be found defective to transport children to placement locations in Riverside County. On two (2) separate occasions while transporting children and family members CPS staff experienced major mechanical problems, including brake malfunction and parts falling off the vehicle.
Recomendaciones relacionadas (1)
R8:
The Department of Mental Health in Blythe, provide the court required Substance Abuse counseling and other needed Mental Health Services for family members prior to returning the child to their home. Report Issued: 06/23/04 Report Public: 06/25/04 Response Due: 09/21/04 5
F9:
Blythe CPS teleconferencing system, which is utilized for training and would reduce traveling to Indio, has been inoperative for approximately two years.
F10:
The Blythe CPS Office budgeted position and actual staffing are shown in the chart below: Positions Title Budgeted Actual Social Worker 5 3 Office Assistant 1 1 Receptionist 1 0 Social Service Assistant 1 1 Total 8 5 4
Hallazgos & Recomendaciones
7 hallazgos
F1:
Traffic signs erected without the approval of the City Traffic Engineer are not enforceable.
F2:
The City Traffic Engineer Department does not have procedures and/or policies in place to remove traffic control markings, signs, and signals, which have been erected without the approval of the City Traffic Engineer.
Recomendaciones relacionadas (3)
R2:
The City Traffic Engineer must develop procedures and policies regarding the request for the placement or removal of traffic control markings, signs and signals.
R3:
Procedures and policies for placement or removal of traffic control markings, signs and signals are made available to the general public and law enforcement.
R4:
City of Indio Police Department develop procedures and policies to insure that all City of Indio Police Officers follow proper procedures for placement of enforceable traffic control signs. 3
F3:
Employees of the Desert Sands Unified School District, acting upon the request of an Indio Police Department Patrol Officer, placed a “Right Turn Only” sign at the single lane exit leading from the Johnson Elementary School to the intersection of Clinton and Alberta Streets in Indio. A “Right Turn Only” sign was also placed at the double exit lane leading from the Johnson Elementary School to the intersection of Clinton and Palmyra Streets. Neither sign was authorized by the City Traffic Engineer.
Recomendaciones relacionadas (1)
R1:
The City Traffic Engineer should remove or formally approve the unauthorized traffic control markings, signs or signals at Johnson Elementary School in accordance with state law.
F4:
Properly authorized and painted traffic flow markers at the double exit lanes from the Johnson Elementary School were altered without the approval of the City Traffic Engineer.
Recomendaciones relacionadas (1)
R1:
The City Traffic Engineer should remove or formally approve the unauthorized traffic control markings, signs or signals at Johnson Elementary School in accordance with state law.
F5:
A third exit from the Johnson Elementary School onto Clinton Street also has an unauthorized “International” no left turn sign.
Recomendaciones relacionadas (1)
R1:
The City Traffic Engineer should remove or formally approve the unauthorized traffic control markings, signs or signals at Johnson Elementary School in accordance with state law.
F6:
A school district bus driver was cited for violating one of these unauthorized signs. Although the citation was later dismissed, the bus driver incurred inconvenience and considerable expense.
F7:
The City Traffic Engineer allowed the signs to remain in place, once learning of their existence. 2
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Hallazgos & Recomendaciones
17 hallazgos
F1:
On February 3, 2003, the Office of the Public Guardian recommended that the Client be placed at Villa La Roe (VLR), describing that facility as “a facility that provides care and treatment for persons suffering from dementia and need assistance with their daily living activities”. The officer making that
F2:
As required under Title 22, Article 6, Section 87584 (Functional Capabilities) the RCFE did not assess the Clients need for care and ability to perform the function of daily living. The Client was hard of hearing, had no dentures, stopped eating, drinking and taking medication. The RCFE Administrator and staff did not report these changes to the DMH Case Manager, conservator or physician.
F3:
In mid-June 2003, a Clinical Nurse from the Hemet Mental Health Clinic temporarily replaced the Client’s regularly assigned RN/Case Manager. On June 16, 2003, this Clinical Nurse called the Facility’s Administrator to discuss the Client’s condition. The Facility Administrator reported that the Client was “stable, doing well, eating okay and taking prescribed medication.”
F4:
On June 23, 2003, a Clinical Nurse, and a Behavioral Health Specialist from the Hemet Mental Health Clinic made an unannounced visit to the VLR to meet the Client and Facility Administrator. Pursuant to Welfare & Institution Code, a Clinical Nurse is a mandated reporter. (a) “Any person who has assumed full or intermittent responsibility for care or custody of an elder or dependent adult, whether or not that person receives compensation, including administrators, supervisors, and any licensed staff of a public or private facility that provides care or services for elder or dependent adults, or any elder or dependent adult care 5 custodian, health practitioner, or employee of a county adult protective services agency or a local law enforcement agency is a mandated reporter.” Source: Welfare & Institutions Code, Chapter 11, Article 3, Section 15630 Mandated Reporter. They were greeted by an 18-year old male staff member, who escorted them to the Client’s room. The male staff member informed the nurse, “The Client had not eaten for 4-5 days”. The Clinical Nurse and Behavioral Health Specialist entered the Client’s room and observed the following conditions: a. No bedding. b. Client lying half off the bed on right side, legs dangling on floor. c. Nude from waist down. d. Disoriented. e. Client moaning, “I’m in pain, I’m diabetic”. f. A bowl of applesauce on the dirty un-vacuumed carpet. g. Feces smeared towels littered on the bathroom floor.
F5:
The Clinical Nurse immediately called “911” and the Client was transported by ambulance to SGMH for emergency medical care. The Clinical Nurse did not report the conditions described in 4a – 4g despite provisions of Mental Health Policy #218, that required reporting of possible elder abuse and neglect.
F6:
The emergency room physician at SGMH stated that the Client had “severe urinary tract infection (urosepis) with mild dehydration and possible neglect and abuse”.
F7:
After the emergency room physician evaluated the Client and established a diagnosis, the Client was admitted to SGMH for treatment and care. The Client’s medical condition did not improve and subsequently died on July 1, 2003.
F8:
The social worker at SGMH reported the possible neglect and abuse. Adult Protective Services did not intervene.
F9:
VLR Administrator and staff failed to seek medical attention for the Client even after staff observed that the Client would not eat, drink or take medication and was losing weight rapidly. 6
Recomendaciones relacionadas (1)
R1:
Upon a conservatee entering a RCFE, the Office of Public Guardian and Department of Mental Health provide a list of service expectations and communication requirements for a conservatee. The following must be provided: a. Notify the Public Guardian immediately when a conservatee experiences an accident or injury. b. Notify the Public Guardian and/or caseworker when a conservatee refuses to eat, drink or take medication. c. Notify the Public Guardian when the health of the conservatee dramatically changes. d. Notify the Public Guardian when a conservatee is taken to the hospital emergency room for treatment or admitted to the hospital as a patient.
F10:
The Department of Mental Health failed to advise the Office of the Public Guardian that Dementia Probate Conservatorship had been approved for the Client on March 27, 2003.
Recomendaciones relacionadas (1)
R11:
The Department of Mental Health and Office of the Public Guardian take the lead to initiate an annual workshop that bring together representatives from the following agencies: • Community Care Licensing • Mental Health Nurses and caseworkers • Public Guardian Deputies and Nurses • Adult Protective Services The purpose of this annual workshop is to share ideas, establish and/or recommend policy changes, improve communication, and share data so that the service delivery to the elderly clients in RCFE’s will be maintained at the highest quality and delivered with dignity and compassion. Report Issued: 06/14/04 Report Public: 06/16/04 Response Due: 09/13/04 15
F11:
The Office of the Public Guardian neglected to consult with CCL regarding the licensee status or suitability of placement for dementia residents at VLR (RCFE).
Recomendaciones relacionadas (6)
R2:
Community Care Licensing develop and implement a computer based RCFE rating system that would be accessible to the PG and DMH staff to assist them in selecting the appropriate RCFE that would best meet the conservatee’s needs.
R3:
Placement of a conservatee shall not be made by the PG and DMH until a suitable and qualified RCFE is selected.
R4:
Public Guardian - Conservatorship Branch personally visit selected placement RCFE’s prior to submitting a recommendation to the County Counsel and the Superior Court and on a regular scheduled basis thereafter.
R9:
The Office of the Public Guardian be held responsible to insure that RCFE’s are adequately equipped with qualified staff and are also in compliance with Title 22, Article 8, Section 87724 for the clients placed in their facilities.
R10:
That formal disciplinary action be taken against the person or persons responsible for placing the Client into a RCFE that did not have trained staff to handle dementia patients or a “Dementia Waiver”.
R11:
The Department of Mental Health and Office of the Public Guardian take the lead to initiate an annual workshop that bring together representatives from the following agencies: • Community Care Licensing • Mental Health Nurses and caseworkers • Public Guardian Deputies and Nurses • Adult Protective Services The purpose of this annual workshop is to share ideas, establish and/or recommend policy changes, improve communication, and share data so that the service delivery to the elderly clients in RCFE’s will be maintained at the highest quality and delivered with dignity and compassion. Report Issued: 06/14/04 Report Public: 06/16/04 Response Due: 09/13/04 15
F12:
Evidence shows that the Policies and Operating Procedures that were established in 1988 in the PG’s Policy and Procedure Manuals have not been updated since 1998. Current Operating Procedures are not reflected in the manual.
Recomendaciones relacionadas (1)
R7:
Office of the Public Guardian revise and/or update all job descriptions and hold each staff member accountable for maintaining the performance standards within the scope of their duties and responsibilities.
F13:
VLR violated Article 3, Section 87227 of the CCL Manual Policies and Procedures by failing to surrender all cash (from Client’s spending account) resources, personal property and valuables to the Office of the Public Guardian upon the death of Client.
Recomendaciones relacionadas (1)
R5:
Public Guardian RCFE’s to submit a quarterly spending account report to the Office of the Public Guardian and surrender any cash upon the death of the conservatee. 14
F14:
On July 7, 2003, a CCL Licensed Program Analyst conducted an investigation at Villa La Roe and substantiated “client neglect care” allegations through the examination of RCFE documents.
F15:
The following data summarizes deficiencies documented by CCL at Villa La Roe from February 14, 2002 through September 19, 2003. . 7
Recomendaciones relacionadas (2)
R6:
Community Care Licensing enforce the RCFE licensing and certification standards for licensees and administrators to be in strict compliance with all licensing requirements.
R8:
CCL reinforce policies and implement stiffer monetary penalties for RCFE’s non-compliance with licensing laws by establishing criteria and consequences based on the severity of the deficiency and/or repeated recurrence of the same deficiency.
F16:
Table I summarizes the deficiencies that were found by Licensed Program Analyst (LPA), CCL. Table 1 FACILITY DEFICIENCIES OBSERVED BY CCL DURING UNANNOUNCED VISITS AND INSPECTIONS DATE CODE VIOLATION INSPECTION DEF DESCRIPTION TYPE 2/14/02 87101 (r)(4) Case A Non-Compatible Residents Management Exceeded the number of allowed adults (ages 18-59) living in this elderly facility. 3/25/02 87575 (h)(2) Case A Medication & Centrally Stored Management Medication Records Prescribed medication for one resident was found on the top of a filing cabinet in an office with the door unlocked. 87575 (a)(6) A The RCFE did not consistently or adequately monitor a resident’s self- administered medication. A A bubble pack prescription for one resident had pills missing. The RCFE was not consistent in assisting residents with self-administered medication. 87575 (h)(6) A A resident’s medication was not A,B,C,D,E,F properly documented on the Centrally Stored Medication Record. DATE CODE VIOLATION INSPECTION DEF DESCRIPTION TYPE 4/5/02 87703 (b)(3)(B) Case A Oxygen Administration Management The RCFE does not have the required signs posted which reads “No Smoking Oxygen in Use”. 87703 (b)(3)(E) A Four (4) oxygen tanks were placed in bedroom #2 without being secured in a stand or to the wall. 87575 (b)(3)(F) A An unauthorized extension to the standard seven (7) foot plastic tubing from nasal cannula on mask to the main source of the oxygen tank 11/08/02 87691 (i)(A)(B)(C) Annual A Maintenance and Operations The signal system in a resident’s bedroom was inoperative. 87691 (a) A The Carpeting in a resident’s room and throughout the common areas of the facility was dirty and stained. 87691 (a) A Toilet seat in a resident’s bedroom was loose and not secured to the toilet seat. 87691 (a)(b) A Door leading to the outside of a resident’s room was not properly fitted to the frame, allowing cold air to enter. DATE CODE VIOLATION INSPECTION DEF DESCRIPTION TYPE Maintenance and Operations 11/08/02 87691 (a)(b) Annual A Cold Air coming through the vents of the air conditioning units located in a resident’s window. 87691 (a)(e)(5) B The floor mats in a majority of the resident’s bath tub/shower were dirty and worn. A Freezer in hallway blocking the exit to a resident’s bedroom. Personal Rights 03/01/03 87572 (a)(1,2,3) Case A An elderly resident was sharing a Management room with an adult resident (under 60) who was loud, confrontational and intimidating with other residents. Definitions: “Residential Care Facility for the Elderly” 87101 (r) (4) A The facility exceeded the number of adults (ages 18-59) allowed to be living with the elderly. Personal Accommodation & Services 03/10/03 87677 (A)(2)(C) Case A One resident was using another Management resident’s bedroom as a passageway to the bedroom and toilet. Limitations 87582 (B)(6) A Three adult residents yelled, cursed, threatened staff, and intimidated the elderly population living in the RCFE. Care of Persons with Dementia 03/11/03 87724 (c) A An elderly resident was not able to demonstrate with mental competence or physical ability that she could exit the facility in case of an emergency. Medical Assessment 07/07/03 87569(a)(b)(1)(2)(4) Complaint Facility transfer document on files Investigation dated 2/27/03 revealed that EM had a diagnosis of diabetes and was prescribed” sliding scale insulin” yet medical assessment on file at facility completed by the physician makes no mention of diabetes or what diabetic care is required Incidental Medical & Dental Care 07/02/03 87575 (a)(1) Complaint A The RCFE administrator and/or staff Investigation failed to seek appropriate medical care for the resident EM when she stopped eating, drinking and taking medication. Observation of Resident 87591 Resident A The RCFE did not provide appropriate Observation assistance in a timely manner when a resident’s condition was deteriorating and she was loosing weight. Maintenance & Operations 09/10/03 87691 (1) Case A The RCFE’s stove/oven in the kitchen Management was not in proper working condition. The oven thermostat was inoperative resulting in incorrect oven temperature. Provisions & Upkeep of Regulations 09/10/03 Health & Safety Code Case A There was no proof on file that the 1569.155 Management licensee subscribed to an appropriate regulation subscription services. Food Service 87576 (b)(26) B There was an insufficient supply of perishable food on hand to meet the needs of 14 residents for two (2) days. Maintenance & Operations 09/19/03 87691 (a) B The flooring in one resident’s bedroom had numerous missing tiles and the area where the tiles were missing was dirty. 09/19/03 87691(a) The carpeting in six (6) resident’s bedrooms was dirty, worn and stained. A citation for this violation was issued on 11/08/02. Type A: Deficiency Violations of the regulations and/or Health and Safety Codes, that if not corrected, has a direct and immediate risk health, safety and personal rights or clients in care. Type B: Deficiency Violations of the regulations and/or the Health and Safety Codes that, without correction, could become a risk to the Health, safety or personal rights of clients, a record keeping violation that would impact the care of clients and/or protections of their resources, or a violation that would impact those services required to meet the client’s needs. 13
F60:
who was loud, confrontational and intimidating with other residents. Definitions: “Residential Care Facility for the Elderly” 87101 (r) (4) A The facility exceeded the number of adults (ages 18-59) allowed to be living with the elderly. Personal Accommodation & Services 03/10/03 87677 (A)(2)(C) Case A One resident was using another Management resident’s bedroom as a passageway to the bedroom and toilet. Limitations 87582 (B)(6) A Three adult residents yelled, cursed, threatened staff, and intimidated the elderly population living in the RCFE. Care of Persons with Dementia 03/11/03 87724 (c) A An elderly resident was not able to demonstrate with mental competence or physical ability that she could exit the facility in case of an emergency. Medical Assessment 07/07/03 87569(a)(b)(1)(2)(4) Complaint Facility transfer document on files Investigation dated 2/27/03 revealed that EM had a diagnosis of diabetes and was prescribed” sliding scale insulin” yet medical assessment on file at facility completed by the physician makes no mention of diabetes or what diabetic care is required Incidental Medical & Dental Care 07/02/03 87575 (a)(1) Complaint A The RCFE administrator and/or staff Investigation failed to seek appropriate medical care for the resident EM when she stopped eating, drinking and taking medication. Observation of Resident 87591 Resident A The RCFE did not provide appropriate Observation assistance in a timely manner when a resident’s condition was deteriorating and she was loosing weight. Maintenance & Operations 09/10/03 87691 (1) Case A The RCFE’s stove/oven in the kitchen Management was not in proper working condition. The oven thermostat was inoperative resulting in incorrect oven temperature. Provisions & Upkeep of Regulations 09/10/03 Health & Safety Code Case A There was no proof on file that the 1569.155 Management licensee subscribed to an appropriate regulation subscription services. Food Service 87576 (b)(26) B There was an insufficient supply of perishable food on hand to meet the needs of 14 residents for two (2) days. Maintenance & Operations 09/19/03 87691 (a) B The flooring in one resident’s bedroom had numerous missing tiles and the area where the tiles were missing was dirty. 09/19/03 87691(a) The carpeting in six (6) resident’s bedrooms was dirty, worn and stained. A citation for this violation was issued on 11/08/02. Type A: Deficiency Violations of the regulations and/or Health and Safety Codes, that if not corrected, has a direct and immediate risk health, safety and personal rights or clients in care. Type B: Deficiency Violations of the regulations and/or the Health and Safety Codes that, without correction, could become a risk to the Health, safety or personal rights of clients, a record keeping violation that would impact the care of clients and/or protections of their resources, or a violation that would impact those services required to meet the client’s needs. 13
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Hallazgos & Recomendaciones
17 hallazgos
F1:
On February 3, 2003, the Office of the Public Guardian recommended that the Client be placed at Villa La Roe (VLR), describing that facility as “a facility that provides care and treatment for persons suffering from dementia and need assistance with their daily living activities”. The officer making that
F2:
As required under Title 22, Article 6, Section 87584 (Functional Capabilities) the RCFE did not assess the Clients need for care and ability to perform the function of daily living. The Client was hard of hearing, had no dentures, stopped eating, drinking and taking medication. The RCFE Administrator and staff did not report these changes to the DMH Case Manager, conservator or physician.
Recomendaciones relacionadas (1)
R9:
The Office of the Public Guardian be held responsible to insure that RCFE’s are adequately equipped with qualified staff and are also in compliance with Title 22, Article 8, Section 87724 for the clients placed in their facilities.
F3:
In mid-June 2003, a Clinical Nurse from the Hemet Mental Health Clinic temporarily replaced the Client’s regularly assigned RN/Case Manager. On June 16, 2003, this Clinical Nurse called the Facility’s Administrator to discuss the Client’s condition. The Facility Administrator reported that the Client was “stable, doing well, eating okay and taking prescribed medication.”
F4:
On June 23, 2003, a Clinical Nurse, and a Behavioral Health Specialist from the Hemet Mental Health Clinic made an unannounced visit to the VLR to meet the Client and Facility Administrator. Pursuant to Welfare & Institution Code, a Clinical Nurse is a mandated reporter. (a) “Any person who has assumed full or intermittent responsibility for care or custody of an elder or dependent adult, whether or not that person receives compensation, including administrators, supervisors, and any licensed staff of a public or private facility that provides care or services for elder or dependent adults, or any elder or dependent adult care 5 custodian, health practitioner, or employee of a county adult protective services agency or a local law enforcement agency is a mandated reporter.” Source: Welfare & Institutions Code, Chapter 11, Article 3, Section 15630 Mandated Reporter. They were greeted by an 18-year old male staff member, who escorted them to the Client’s room. The male staff member informed the nurse, “The Client had not eaten for 4-5 days”. The Clinical Nurse and Behavioral Health Specialist entered the Client’s room and observed the following conditions: a. No bedding. b. Client lying half off the bed on right side, legs dangling on floor. c. Nude from waist down. d. Disoriented. e. Client moaning, “I’m in pain, I’m diabetic”. f. A bowl of applesauce on the dirty un-vacuumed carpet. g. Feces smeared towels littered on the bathroom floor.
F5:
The Clinical Nurse immediately called “911” and the Client was transported by ambulance to SGMH for emergency medical care. The Clinical Nurse did not report the conditions described in 4a – 4g despite provisions of Mental Health Policy #218, that required reporting of possible elder abuse and neglect.
F6:
The emergency room physician at SGMH stated that the Client had “severe urinary tract infection (urosepis) with mild dehydration and possible neglect and abuse”.
F7:
After the emergency room physician evaluated the Client and established a diagnosis, the Client was admitted to SGMH for treatment and care. The Client’s medical condition did not improve and subsequently died on July 1, 2003.
F8:
The social worker at SGMH reported the possible neglect and abuse. Adult Protective Services did not intervene.
F9:
VLR Administrator and staff failed to seek medical attention for the Client even after staff observed that the Client would not eat, drink or take medication and was losing weight rapidly. 6
Recomendaciones relacionadas (1)
R1:
Upon a conservatee entering a RCFE, the Office of Public Guardian and Department of Mental Health provide a list of service expectations and communication requirements for a conservatee. The following must be provided: a. Notify the Public Guardian immediately when a conservatee experiences an accident or injury. b. Notify the Public Guardian and/or caseworker when a conservatee refuses to eat, drink or take medication. c. Notify the Public Guardian when the health of the conservatee dramatically changes. d. Notify the Public Guardian when a conservatee is taken to the hospital emergency room for treatment or admitted to the hospital as a patient.
F10:
The Department of Mental Health failed to advise the Office of the Public Guardian that Dementia Probate Conservatorship had been approved for the Client on March 27, 2003.
F11:
The Office of the Public Guardian neglected to consult with CCL regarding the licensee status or suitability of placement for dementia residents at VLR (RCFE).
Recomendaciones relacionadas (4)
R2:
Community Care Licensing develop and implement a computer based RCFE rating system that would be accessible to the PG and DMH staff to assist them in selecting the appropriate RCFE that would best meet the conservatee’s needs.
R3:
Placement of a conservatee shall not be made by the PG and DMH until a suitable and qualified RCFE is selected.
R4:
Public Guardian - Conservatorship Branch personally visit selected placement RCFE’s prior to submitting a recommendation to the County Counsel and the Superior Court and on a regular scheduled basis thereafter.
R10:
That formal disciplinary action be taken against the person or persons responsible for placing the Client into a RCFE that did not have trained staff to handle dementia patients or a “Dementia Waiver”.
F12:
Evidence shows that the Policies and Operating Procedures that were established in 1988 in the PG’s Policy and Procedure Manuals have not been updated since 1998. Current Operating Procedures are not reflected in the manual.
Recomendaciones relacionadas (2)
R7:
Office of the Public Guardian revise and/or update all job descriptions and hold each staff member accountable for maintaining the performance standards within the scope of their duties and responsibilities.
R11:
The Department of Mental Health and Office of the Public Guardian take the lead to initiate an annual workshop that bring together representatives from the following agencies: • Community Care Licensing • Mental Health Nurses and caseworkers • Public Guardian Deputies and Nurses • Adult Protective Services The purpose of this annual workshop is to share ideas, establish and/or recommend policy changes, improve communication, and share data so that the service delivery to the elderly clients in RCFE’s will be maintained at the highest quality and delivered with dignity and compassion. Report Issued: 06/14/04 Report Public: 06/16/04 Response Due: 09/13/04 15
F13:
VLR violated Article 3, Section 87227 of the CCL Manual Policies and Procedures by failing to surrender all cash (from Client’s spending account) resources, personal property and valuables to the Office of the Public Guardian upon the death of Client.
Recomendaciones relacionadas (1)
R5:
Public Guardian RCFE’s to submit a quarterly spending account report to the Office of the Public Guardian and surrender any cash upon the death of the conservatee. 14
F14:
On July 7, 2003, a CCL Licensed Program Analyst conducted an investigation at Villa La Roe and substantiated “client neglect care” allegations through the examination of RCFE documents.
F15:
The following data summarizes deficiencies documented by CCL at Villa La Roe from February 14, 2002 through September 19, 2003. . 7
Recomendaciones relacionadas (2)
R6:
Community Care Licensing enforce the RCFE licensing and certification standards for licensees and administrators to be in strict compliance with all licensing requirements.
R8:
CCL reinforce policies and implement stiffer monetary penalties for RCFE’s non-compliance with licensing laws by establishing criteria and consequences based on the severity of the deficiency and/or repeated recurrence of the same deficiency.
F16:
Table I summarizes the deficiencies that were found by Licensed Program Analyst (LPA), CCL. Table 1 FACILITY DEFICIENCIES OBSERVED BY CCL DURING UNANNOUNCED VISITS AND INSPECTIONS DATE CODE VIOLATION INSPECTION DEF DESCRIPTION TYPE 2/14/02 87101 (r)(4) Case A Non-Compatible Residents Management Exceeded the number of allowed adults (ages 18-59) living in this elderly facility. 3/25/02 87575 (h)(2) Case A Medication & Centrally Stored Management Medication Records Prescribed medication for one resident was found on the top of a filing cabinet in an office with the door unlocked. 87575 (a)(6) A The RCFE did not consistently or adequately monitor a resident’s self- administered medication. A A bubble pack prescription for one resident had pills missing. The RCFE was not consistent in assisting residents with self-administered medication. 87575 (h)(6) A A resident’s medication was not A,B,C,D,E,F properly documented on the Centrally Stored Medication Record. DATE CODE VIOLATION INSPECTION DEF DESCRIPTION TYPE 4/5/02 87703 (b)(3)(B) Case A Oxygen Administration Management The RCFE does not have the required signs posted which reads “No Smoking Oxygen in Use”. 87703 (b)(3)(E) A Four (4) oxygen tanks were placed in bedroom #2 without being secured in a stand or to the wall. 87575 (b)(3)(F) A An unauthorized extension to the standard seven (7) foot plastic tubing from nasal cannula on mask to the main source of the oxygen tank 11/08/02 87691 (i)(A)(B)(C) Annual A Maintenance and Operations The signal system in a resident’s bedroom was inoperative. 87691 (a) A The Carpeting in a resident’s room and throughout the common areas of the facility was dirty and stained. 87691 (a) A Toilet seat in a resident’s bedroom was loose and not secured to the toilet seat. 87691 (a)(b) A Door leading to the outside of a resident’s room was not properly fitted to the frame, allowing cold air to enter. DATE CODE VIOLATION INSPECTION DEF DESCRIPTION TYPE Maintenance and Operations 11/08/02 87691 (a)(b) Annual A Cold Air coming through the vents of the air conditioning units located in a resident’s window. 87691 (a)(e)(5) B The floor mats in a majority of the resident’s bath tub/shower were dirty and worn. A Freezer in hallway blocking the exit to a resident’s bedroom. Personal Rights 03/01/03 87572 (a)(1,2,3) Case A An elderly resident was sharing a Management room with an adult resident (under 60) who was loud, confrontational and intimidating with other residents. Definitions: “Residential Care Facility for the Elderly” 87101 (r) (4) A The facility exceeded the number of adults (ages 18-59) allowed to be living with the elderly. Personal Accommodation & Services 03/10/03 87677 (A)(2)(C) Case A One resident was using another Management resident’s bedroom as a passageway to the bedroom and toilet. Limitations 87582 (B)(6) A Three adult residents yelled, cursed, threatened staff, and intimidated the elderly population living in the RCFE. Care of Persons with Dementia 03/11/03 87724 (c) A An elderly resident was not able to demonstrate with mental competence or physical ability that she could exit the facility in case of an emergency. Medical Assessment 07/07/03 87569(a)(b)(1)(2)(4) Complaint Facility transfer document on files Investigation dated 2/27/03 revealed that EM had a diagnosis of diabetes and was prescribed” sliding scale insulin” yet medical assessment on file at facility completed by the physician makes no mention of diabetes or what diabetic care is required Incidental Medical & Dental Care 07/02/03 87575 (a)(1) Complaint A The RCFE administrator and/or staff Investigation failed to seek appropriate medical care for the resident EM when she stopped eating, drinking and taking medication. Observation of Resident 87591 Resident A The RCFE did not provide appropriate Observation assistance in a timely manner when a resident’s condition was deteriorating and she was loosing weight. Maintenance & Operations 09/10/03 87691 (1) Case A The RCFE’s stove/oven in the kitchen Management was not in proper working condition. The oven thermostat was inoperative resulting in incorrect oven temperature. Provisions & Upkeep of Regulations 09/10/03 Health & Safety Code Case A There was no proof on file that the 1569.155 Management licensee subscribed to an appropriate regulation subscription services. Food Service 87576 (b)(26) B There was an insufficient supply of perishable food on hand to meet the needs of 14 residents for two (2) days. Maintenance & Operations 09/19/03 87691 (a) B The flooring in one resident’s bedroom had numerous missing tiles and the area where the tiles were missing was dirty. 09/19/03 87691(a) The carpeting in six (6) resident’s bedrooms was dirty, worn and stained. A citation for this violation was issued on 11/08/02. Type A: Deficiency Violations of the regulations and/or Health and Safety Codes, that if not corrected, has a direct and immediate risk health, safety and personal rights or clients in care. Type B: Deficiency Violations of the regulations and/or the Health and Safety Codes that, without correction, could become a risk to the Health, safety or personal rights of clients, a record keeping violation that would impact the care of clients and/or protections of their resources, or a violation that would impact those services required to meet the client’s needs. 13
F60:
who was loud, confrontational and intimidating with other residents. Definitions: “Residential Care Facility for the Elderly” 87101 (r) (4) A The facility exceeded the number of adults (ages 18-59) allowed to be living with the elderly. Personal Accommodation & Services 03/10/03 87677 (A)(2)(C) Case A One resident was using another Management resident’s bedroom as a passageway to the bedroom and toilet. Limitations 87582 (B)(6) A Three adult residents yelled, cursed, threatened staff, and intimidated the elderly population living in the RCFE. Care of Persons with Dementia 03/11/03 87724 (c) A An elderly resident was not able to demonstrate with mental competence or physical ability that she could exit the facility in case of an emergency. Medical Assessment 07/07/03 87569(a)(b)(1)(2)(4) Complaint Facility transfer document on files Investigation dated 2/27/03 revealed that EM had a diagnosis of diabetes and was prescribed” sliding scale insulin” yet medical assessment on file at facility completed by the physician makes no mention of diabetes or what diabetic care is required Incidental Medical & Dental Care 07/02/03 87575 (a)(1) Complaint A The RCFE administrator and/or staff Investigation failed to seek appropriate medical care for the resident EM when she stopped eating, drinking and taking medication. Observation of Resident 87591 Resident A The RCFE did not provide appropriate Observation assistance in a timely manner when a resident’s condition was deteriorating and she was loosing weight. Maintenance & Operations 09/10/03 87691 (1) Case A The RCFE’s stove/oven in the kitchen Management was not in proper working condition. The oven thermostat was inoperative resulting in incorrect oven temperature. Provisions & Upkeep of Regulations 09/10/03 Health & Safety Code Case A There was no proof on file that the 1569.155 Management licensee subscribed to an appropriate regulation subscription services. Food Service 87576 (b)(26) B There was an insufficient supply of perishable food on hand to meet the needs of 14 residents for two (2) days. Maintenance & Operations 09/19/03 87691 (a) B The flooring in one resident’s bedroom had numerous missing tiles and the area where the tiles were missing was dirty. 09/19/03 87691(a) The carpeting in six (6) resident’s bedrooms was dirty, worn and stained. A citation for this violation was issued on 11/08/02. Type A: Deficiency Violations of the regulations and/or Health and Safety Codes, that if not corrected, has a direct and immediate risk health, safety and personal rights or clients in care. Type B: Deficiency Violations of the regulations and/or the Health and Safety Codes that, without correction, could become a risk to the Health, safety or personal rights of clients, a record keeping violation that would impact the care of clients and/or protections of their resources, or a violation that would impact those services required to meet the client’s needs. 13
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Hallazgos & Recomendaciones
9 hallazgos
F1:
The FY 2003-2004 budget for TAP was set at twenty five million dollars ($25,000,000), 37 funded employees and 1035 inventory part-time personnel, reflecting an increase of five hundred percent (500%) over that of FY 1998-1999. Based on the Business Plan (Form 11) submitted to the Board of Supervisors the budget increase over 5 years would be twenty percent (20%) for a budget of $6,428,400.
Recomendaciones relacionadas (1)
R1:
Human Resources reduce the size and budget of TAP to its FY 1998-1999 size including the increased projected by the March 1998 Business Plan, resulting in a budget of $6,428,400. The Form 11 and supporting documents submitted to the Board of Supervisors for the establishment of the TAP Program stated that a twenty percent (20%) increase was projected for the five year period following FY 1998-1999. This translates into a budget of six million, four hundred twenty eight thousand dollar ($6,428,020) for FY 2003-2004. If one used the Cost of Living Index for the Los Angeles, Long Beach, and Riverside area of sixteen percent (16%) for the same period, the figure would be about two hundred thousand dollars ($200,000) less.
F2:
Since its inception in 1998, the TAP function has not been audited.
Recomendaciones relacionadas (1)
R2:
The County Auditor-Controller conduct a full audit of the TAP function within the Department of Human Resources. 4
F3:
County employment has grown from approximately 12,000 employees in 1998 to over 19,000 in 2003. During this period, 2,659 temporary employees were transferred to permanent status. In addition, 12,374 employees were hired through the Resumix System. The Resumix System is a computer based program matching resumes to job descriptions. A total of 8,000 employees transitioned out of the County, resulting in an employee turnover rate of forty-two percent (42%).
Recomendaciones relacionadas (1)
R3:
Since the Auditor-Controller performs fiscal audits only, it is recommended an independent managerial auditing firm be hired to conduct a study to report on the following: a) The County employee turnover rate. b) High incidence of temporary employee unemployment insurance claims. c) Whether the use of temporary employees was required by an operational necessity or unanticipated event.
F4:
Each time a person terminates and a new hire is brought in to fill the position, the County incurs additional cost. Based upon information provided by the Riverside County Assistant Director of Human Resources, and by Advantage Hiring, Inc., during the period 1998 through 2003 this cost was fourteen hundred forty dollars ($1,440) per employee for a total of eleven million five hundred twenty thousand dollars ($11,520,000). Note: “True turnover costs are more complex than simply figuring out the average cost of replacement. The costs of losing a good performer are greater than the costs of losing an average performer. The true cost of losing a key seasoned player is hard to estimate. There is the investment in development of the employee, the value of the knowledge and experience gained, 2 and the lost productivity that also have to be considered to arrive at a true cost figure.” Advantage Hiring Inc.
Recomendaciones relacionadas (1)
R4:
Human Resources establish a database so all departments can access current and former employees records for tracking all TAP employees’ records and those who have transitioned to permanent status as County employees. The capability already exists within County Information Technology.
F5:
The County Department of Human Resources has projected that unemployment compensation claims from temporary hires in FY 2003-2004 will approach six million, six hundred thousand dollars ($6,600,000) or approximately ten thousand dollars ($10,000) per claimant. This accounts for more than one-third of such claims filed by all County employees.
Recomendaciones relacionadas (1)
R5:
Human Resources establish specific policies defining the circumstances under which a manager may request the hiring of temporary staff and impose limitations on the number of temporary hires authorized at any given time within each department.
F6:
Sixty eight percent (68%) of permanent County employees currently staffing the TAP function within the Human Resources Department began County employment as temporary hires. This situation creates a duplication of efforts and additional costs to the County.
Recomendaciones relacionadas (1)
R6:
Departments shall not exceed their temporary hire quotas unless the Chief Executive Officer personally authorizes such a hiring increase based upon the existence of a temporary emergency or other non-recurrent necessity.
F7:
On January 24, 2004, the Board of Supervisors ordered all departments to cut spending across the board by eight percent (8%). In spite of the directive, on Sunday, February 22, 2004, a local newspaper carried a County TAP advertisement for new temporary hires in more than thirty (30) positions.
Recomendaciones relacionadas (1)
R7:
Human Resources require that all departments comply with the hiring freeze ordered by the Board of Supervisors.
F8:
Through interviews and documents, it was established that employment decisions were not completely based on merit in the hiring of temporary personnel through TAP. It was found that, in some cases, relatives of supervisory, managerial, or administrative permanent employees were afforded employment consideration not available to other applicants; for example: a) A temporary employee file was found in the archive with a “post-it” note attached stating that the file contained the application of a permanent TAP employee’s daughter. This applicant was immediately hired. b) The spouse of a supervising permanent County employee submitted an application for temporary employment for work that the applicant was not qualified to perform. It was made clear to the employee reviewing the application, that this person would be hired even if the document had to be altered. 3 c) During the course of this inquiry, the Grand Jury physically inspected the employment files of temporary employees in pre-selected alphabetical categories corresponding to the surnames of certain persons known to have been hired by TAP. The alphabetically maintained employment records of some persons known to be related to permanent County employees serving in supervisory capacities could not be located. The records were produced by TAP employees only after specific name requests were made.
Recomendaciones relacionadas (1)
R8:
All TAP applications be amended to require the applicant to disclose the name and permanent duty assignment of any of his or her relatives employed by the County.
F9:
Several employees interviewed stated fears of management retaliation were they to speak candidly with the Grand Jury.
Recomendaciones relacionadas (1)
R9:
TAP permanent employees shall not review, make any recommendation, or take any action, with respect to an employment application submitted by a family member. ATTACHMENT “D” ORDINANCE AND RESOLUTION AMENDMENTS TRANSFER OF FUNDS It is requested the Board approve the following: 1) By Ordinance, amend the Table and Index of Ordinance #440 to add the following classification: CLASS CODE CLASS TITLE SALARY RANGE 13871 Temporary Assistant 0 ($5.75 - $125.00 per hour) 2) By Resolution, amend Ordinance 440, Section 49 (a) Personnel to add the following positions: NUMBER CLASS CODE CLASS TITLE SALARY RANGE +1 74774 Senior Personnel Analyst 350 ($41,787 - $51,750) +1 15915 Accounting Technician I 273 ($27,664 - $34,278) +2 13868 Supervising Office Assistant II 241 ($23,317 - $28,870) 3) By Resolution, amend Ordinance 440, Section 49 (a) Personnel – TEMPORARY to add the following positions: NUMBER CLASS CODE CLASS TITLE SALARY RANGE +200 13817 Temporary Assistant 0 ($5.75 - $125.00 per hour) To be effective on the date of approval. 4) An advancement/transfer of funds of $600,000 to the Personnel Department, Temporary Assistance Program, Fund 706, Organization 951, to fund the initial period of the Temporary Assistance Pool including staff salaries, initial physicals/drug and alcohol testing, hardware and software requirements for testing, tracking and billing, etc. It is anticipated these monies and staff will be transferred to an approved Internal Services Fund, and that the $600,000 will be paid back by June 30, 2000. 5) The budget for the Temporary Assistance Program be set up and the Board approve the recommended appropriations and estimated revenue as attached. 6 1997-1998 APPROPRIATIONS 1-10101 Regular Salaries (+10% increase) $120,000 (1) Senior Personnel Analyst, (1) Accounting Technician, and (2) Supervising OA II positions. 1-11101 Temporary Salaries 1,026,000 Temporary Assistance Pool employees’ salaries 1-20101 Budgeted Benefits/mandated costs 30,500 2-30003 Accounting Services 10,000 RIFMIS for billings/payments to/from departments. 2-35303 Insurance Liability 5,000 Insurance Charge based on employees & mileage driven 2-42101 Office Expense 40,000 Computer hardware and software, printing services, advertisements, etc. 2-42109 Temporary Services 4,000 Paid to external services (and guarantee to cover first 8 hours of TAP employees) 2-43809 Drug Testing 10,000 Physical and drug & alcohol testing per policy 2-50202 Car Pool Mileage 2,000 Staff, when monitoring employees at departments and reviewing departments’ needs, and TAP employees, (mileage billed to/reimbursed by departments) 2-50203 Private Mileage 2,000 Mileage when using personal car is more advantageous 2-50206 Registration/Conference Fees 500 Registration for human resources conferences 2-50208 Meals 0 Meals when out of the area visiting departments or resolving problems TOTAL $ 1,250,000 7 REVENUE 7246 Charges for Current Services/Personnel Services Reimbursement from user departments: $1,250,000 8 ANNUAL OPERATING BUDGET JUSTIFICATION 1-10101 Regular Salaries $ 195,525 (1) Senior Personnel Analyst, (1) Accounting Technician, and (2) Supervising OA II positions. 1-11101 Temporary Salaries 4,000,000 Temporary Assistance Pool employee’s salaries 1-20101 Budgeted Benefits/mandated costs 211,756 TAP = $116,000/Staff = $51,756 + offset of certain employees who work over 1,000 hours 2-30003 Accounting Services 60,000 RIFMIS for billings/payments to/from departments. 2-35303 Insurance Liability 15,000 Insurance Charge based on employees & mileage driven 2-42101 Office Expense 140,000 Computer hardware and software, printing services, advertisement, etc. 2-42109 Temporary Services 459,000 Paid to external services (and guarantee to cover first 8 hours of TAP employees) 2-43809 Drug Testing 35,200 Physical and drug & alcohol testing per policy 2-50202 Car Pool Mileage 2,000 Staff, when monitoring employees at departments and reviewing departments’ needs and TAP employees, (mileage billed to/reimbursed by departments) 2-50203 Private Mileage 2,000 Mileage when using personal car is more advantageous 2-50206 Registration/Conference Fees 500 Registration for human resources conferences 2-50208 Meals Meals when out of the area visiting departments 19 or resolving problems 3-64102 Interest on loan 36,000 REPAY LOAN (1/3 of $600,000) 200,000 (After payback of loan, this amount will be placed in reserve for future computer software purchases, including computer software/hardware for training and testing.) TOTAL $ 5,357,000 9 REVENUE Reimbursement from user departments: Salaries of TAP employees $4,000,000 22.9% markup 916,000 Temporary Services 400,000 $1.00 per hour administrative fee 40,000 Mileage reimbursement for TAP employees 1,000 TOTAL $5,357,000 10
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Hallazgos & Recomendaciones
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F1:
The FY 2003-2004 budget for TAP was set at twenty five million dollars ($25,000,000), 37 funded employees and 1035 inventory part-time personnel, reflecting an increase of five hundred percent (500%) over that of FY 1998-1999. Based on the Business Plan (Form 11) submitted to the Board of Supervisors the budget increase over 5 years would be twenty percent (20%) for a budget of $6,428,400.
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R1:
Human Resources reduce the size and budget of TAP to its FY 1998-1999 size including the increased projected by the March 1998 Business Plan, resulting in a budget of $6,428,400. The Form 11 and supporting documents submitted to the Board of Supervisors for the establishment of the TAP Program stated that a twenty percent (20%) increase was projected for the five year period following FY 1998-1999. This translates into a budget of six million, four hundred twenty eight thousand dollar ($6,428,020) for FY 2003-2004. If one used the Cost of Living Index for the Los Angeles, Long Beach, and Riverside area of sixteen percent (16%) for the same period, the figure would be about two hundred thousand dollars ($200,000) less.
F2:
Since its inception in 1998, the TAP function has not been audited.
Recomendaciones relacionadas (1)
R2:
The County Auditor-Controller conduct a full audit of the TAP function within the Department of Human Resources. 4
F3:
County employment has grown from approximately 12,000 employees in 1998 to over 19,000 in 2003. During this period, 2,659 temporary employees were transferred to permanent status. In addition, 12,374 employees were hired through the Resumix System. The Resumix System is a computer based program matching resumes to job descriptions. A total of 8,000 employees transitioned out of the County, resulting in an employee turnover rate of forty-two percent (42%).
Recomendaciones relacionadas (1)
R3:
Since the Auditor-Controller performs fiscal audits only, it is recommended an independent managerial auditing firm be hired to conduct a study to report on the following: a) The County employee turnover rate. b) High incidence of temporary employee unemployment insurance claims. c) Whether the use of temporary employees was required by an operational necessity or unanticipated event.
F4:
Each time a person terminates and a new hire is brought in to fill the position, the County incurs additional cost. Based upon information provided by the Riverside County Assistant Director of Human Resources, and by Advantage Hiring, Inc., during the period 1998 through 2003 this cost was fourteen hundred forty dollars ($1,440) per employee for a total of eleven million five hundred twenty thousand dollars ($11,520,000). Note: “True turnover costs are more complex than simply figuring out the average cost of replacement. The costs of losing a good performer are greater than the costs of losing an average performer. The true cost of losing a key seasoned player is hard to estimate. There is the investment in development of the employee, the value of the knowledge and experience gained, 2 and the lost productivity that also have to be considered to arrive at a true cost figure.” Advantage Hiring Inc.
Recomendaciones relacionadas (1)
R4:
Human Resources establish a database so all departments can access current and former employees records for tracking all TAP employees’ records and those who have transitioned to permanent status as County employees. The capability already exists within County Information Technology.
F5:
The County Department of Human Resources has projected that unemployment compensation claims from temporary hires in FY 2003-2004 will approach six million, six hundred thousand dollars ($6,600,000) or approximately ten thousand dollars ($10,000) per claimant. This accounts for more than one-third of such claims filed by all County employees.
Recomendaciones relacionadas (1)
R5:
Human Resources establish specific policies defining the circumstances under which a manager may request the hiring of temporary staff and impose limitations on the number of temporary hires authorized at any given time within each department.
F6:
Sixty eight percent (68%) of permanent County employees currently staffing the TAP function within the Human Resources Department began County employment as temporary hires. This situation creates a duplication of efforts and additional costs to the County.
Recomendaciones relacionadas (1)
R6:
Departments shall not exceed their temporary hire quotas unless the Chief Executive Officer personally authorizes such a hiring increase based upon the existence of a temporary emergency or other non-recurrent necessity.
F7:
On January 24, 2004, the Board of Supervisors ordered all departments to cut spending across the board by eight percent (8%). In spite of the directive, on Sunday, February 22, 2004, a local newspaper carried a County TAP advertisement for new temporary hires in more than thirty (30) positions.
Recomendaciones relacionadas (1)
R7:
Human Resources require that all departments comply with the hiring freeze ordered by the Board of Supervisors.
F8:
Through interviews and documents, it was established that employment decisions were not completely based on merit in the hiring of temporary personnel through TAP. It was found that, in some cases, relatives of supervisory, managerial, or administrative permanent employees were afforded employment consideration not available to other applicants; for example: a) A temporary employee file was found in the archive with a “post-it” note attached stating that the file contained the application of a permanent TAP employee’s daughter. This applicant was immediately hired. b) The spouse of a supervising permanent County employee submitted an application for temporary employment for work that the applicant was not qualified to perform. It was made clear to the employee reviewing the application, that this person would be hired even if the document had to be altered. 3 c) During the course of this inquiry, the Grand Jury physically inspected the employment files of temporary employees in pre-selected alphabetical categories corresponding to the surnames of certain persons known to have been hired by TAP. The alphabetically maintained employment records of some persons known to be related to permanent County employees serving in supervisory capacities could not be located. The records were produced by TAP employees only after specific name requests were made.
Recomendaciones relacionadas (1)
R8:
All TAP applications be amended to require the applicant to disclose the name and permanent duty assignment of any of his or her relatives employed by the County.
F9:
Several employees interviewed stated fears of management retaliation were they to speak candidly with the Grand Jury.
Recomendaciones relacionadas (1)
R9:
TAP permanent employees shall not review, make any recommendation, or take any action, with respect to an employment application submitted by a family member. ATTACHMENT “D” ORDINANCE AND RESOLUTION AMENDMENTS TRANSFER OF FUNDS It is requested the Board approve the following: 1) By Ordinance, amend the Table and Index of Ordinance #440 to add the following classification: CLASS CODE CLASS TITLE SALARY RANGE 13871 Temporary Assistant 0 ($5.75 - $125.00 per hour) 2) By Resolution, amend Ordinance 440, Section 49 (a) Personnel to add the following positions: NUMBER CLASS CODE CLASS TITLE SALARY RANGE +1 74774 Senior Personnel Analyst 350 ($41,787 - $51,750) +1 15915 Accounting Technician I 273 ($27,664 - $34,278) +2 13868 Supervising Office Assistant II 241 ($23,317 - $28,870) 3) By Resolution, amend Ordinance 440, Section 49 (a) Personnel – TEMPORARY to add the following positions: NUMBER CLASS CODE CLASS TITLE SALARY RANGE +200 13817 Temporary Assistant 0 ($5.75 - $125.00 per hour) To be effective on the date of approval. 4) An advancement/transfer of funds of $600,000 to the Personnel Department, Temporary Assistance Program, Fund 706, Organization 951, to fund the initial period of the Temporary Assistance Pool including staff salaries, initial physicals/drug and alcohol testing, hardware and software requirements for testing, tracking and billing, etc. It is anticipated these monies and staff will be transferred to an approved Internal Services Fund, and that the $600,000 will be paid back by June 30, 2000. 5) The budget for the Temporary Assistance Program be set up and the Board approve the recommended appropriations and estimated revenue as attached. 6 1997-1998 APPROPRIATIONS 1-10101 Regular Salaries (+10% increase) $120,000 (1) Senior Personnel Analyst, (1) Accounting Technician, and (2) Supervising OA II positions. 1-11101 Temporary Salaries 1,026,000 Temporary Assistance Pool employees’ salaries 1-20101 Budgeted Benefits/mandated costs 30,500 2-30003 Accounting Services 10,000 RIFMIS for billings/payments to/from departments. 2-35303 Insurance Liability 5,000 Insurance Charge based on employees & mileage driven 2-42101 Office Expense 40,000 Computer hardware and software, printing services, advertisements, etc. 2-42109 Temporary Services 4,000 Paid to external services (and guarantee to cover first 8 hours of TAP employees) 2-43809 Drug Testing 10,000 Physical and drug & alcohol testing per policy 2-50202 Car Pool Mileage 2,000 Staff, when monitoring employees at departments and reviewing departments’ needs, and TAP employees, (mileage billed to/reimbursed by departments) 2-50203 Private Mileage 2,000 Mileage when using personal car is more advantageous 2-50206 Registration/Conference Fees 500 Registration for human resources conferences 2-50208 Meals 0 Meals when out of the area visiting departments or resolving problems TOTAL $ 1,250,000 7 REVENUE 7246 Charges for Current Services/Personnel Services Reimbursement from user departments: $1,250,000 8 ANNUAL OPERATING BUDGET JUSTIFICATION 1-10101 Regular Salaries $ 195,525 (1) Senior Personnel Analyst, (1) Accounting Technician, and (2) Supervising OA II positions. 1-11101 Temporary Salaries 4,000,000 Temporary Assistance Pool employee’s salaries 1-20101 Budgeted Benefits/mandated costs 211,756 TAP = $116,000/Staff = $51,756 + offset of certain employees who work over 1,000 hours 2-30003 Accounting Services 60,000 RIFMIS for billings/payments to/from departments. 2-35303 Insurance Liability 15,000 Insurance Charge based on employees & mileage driven 2-42101 Office Expense 140,000 Computer hardware and software, printing services, advertisement, etc. 2-42109 Temporary Services 459,000 Paid to external services (and guarantee to cover first 8 hours of TAP employees) 2-43809 Drug Testing 35,200 Physical and drug & alcohol testing per policy 2-50202 Car Pool Mileage 2,000 Staff, when monitoring employees at departments and reviewing departments’ needs and TAP employees, (mileage billed to/reimbursed by departments) 2-50203 Private Mileage 2,000 Mileage when using personal car is more advantageous 2-50206 Registration/Conference Fees 500 Registration for human resources conferences 2-50208 Meals Meals when out of the area visiting departments 19 or resolving problems 3-64102 Interest on loan 36,000 REPAY LOAN (1/3 of $600,000) 200,000 (After payback of loan, this amount will be placed in reserve for future computer software purchases, including computer software/hardware for training and testing.) TOTAL $ 5,357,000 9 REVENUE Reimbursement from user departments: Salaries of TAP employees $4,000,000 22.9% markup 916,000 Temporary Services 400,000 $1.00 per hour administrative fee 40,000 Mileage reimbursement for TAP employees 1,000 TOTAL $5,357,000 10