Facility Evaluation Report

At 3:30 p.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to continue the annual inspection that was started on April 12, 2024. LPA met with staff, Mildred Gonzales., Aira Bobares and Gemma Baluyut. Lilibeth Lopez, interim administrator, arrived at around 4:30 p.m.

LPA reviewed 4 staff and 3 residents files. Medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Residents' P&I were checked and compared with last recorded balance.

-from 4:05 p.m. to 4:40 pm., quantity of residents' (R1, R2, R3) medications received did not match the quantity on labels on the medications; actual quantity received from the pharmacy were less than the quantity on the labels.

Deficiency is cited from Title 22 California Code of Regulation, and listed on 809D.

Deficiency and plan and proof of correction were discussed with the administrator.

Exit interview conducted. Appeal Rights and copy of this report provided.