Facility Evaluation Report
On 2/25/2026 at 12:15 PM, Licensing Program Analyst (LPA) P. Manalo conducted an unannounced Case Management visit regarding an incident that was reported to CCLD on 02/05/2026. LPA met with Administrator, Rosalinda Amacan, and explained the purpose of the visit.
The incident of missed medication occurred on 02/02/2026. S1 stated that during the afternoon shift change, S2 did not give C1 their afternoon medication but S2 signed the Medication Administration Record (MAR). S1 stated that the facility has implemented for each shift to check the medication bubble pack and MAR to ensure that the clients' medication is given and for each shift nurse to provide a report to the next shift.
During the visit, LPA obtained and reviewed the following documents including but not limited to MAR, staff schedule, and staff communication log via phone.
The following deficiencies have been observed:
LPA observed the MAR signed by the S2. Interview with S2 revealed that S2 did sign the MAR on 02/02/2026 and the medication was not provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction