Facility Evaluation Report

On this day at around 3:30pm, Licensing Program Analysts (LPAs) Luisa Fontanilla and Kelly Nguyen arrived unannounced to conduct a case management visit and met with Gina Velayo. LPA explained to Velayo the purpose of the visit.

During the course of investigation of complaint # 15-AS-20230718143211, the Department conducted interviews and reviewed records. Based on interviews conducted, S1 found R1 unconscious at 5 am and called S2 immediately. LPA interviewed S2 who states that S2 responded and went to R1’s room which is on the 2 nd floor of the building using the elevator. Once S2 was in R1’s room and saw R1, S2 went downstairs to check R1’s file if R1 has Do Not Resuscitate (DNR). When asked by LPA if S2 performed CPR to R1, S2 does not recall because the incident happened so fast and he “blacked out” but remembered calling S3, another Medication Technician on shift. S1 and S2 both state S3 performed CPR on R1.

S2 placed the 911 call recorded at 5:21 am.

Deficiency is cited per Title 22 California Code of Regulations. Failure to correct the cited deficiency on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.