Facility Evaluation Report

On 4/10/2024 at 2:45PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct Case Management - Annual Continuation. LPA met with Administrator, Emilissa Pangilinan and explained the reason for the visit.

During visit, LPA interviewed 3 clients and 2 staff starting at 3:30PM. At around 4:10PM, LPA reviewed a sample of client's' medications with their centrally stored records and MAR (Medication Administration Records).

At 3:00PM, LPA observed S1 and S2 does not have health screening on file.

At 3:05PM, LPA observed S1 and S2 does not have TB test results on file.

At 3:10PM, LPA observed C1 does not have current IPP or needs and service plan on file.

At 4:10PM, LPA observed client's medications are prepared a week in advance and placed in weekly containers for each clients. The medications were out of its originally received container.

At 4:40PM, LPA observed C1 ran out of Amlodipine 2.5mg and facility does not have medication available.

The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights provided.