Facility Evaluation Report

Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct proof of correction (POC) visit, and granted entry by Maria Manjarez, staff. LPA called and spoke over the phone with Ferdinand Gutierrez, administrator, and informed the reason for visit. Administrator arrived after about 15 minutes.

On 7/18/23, LPA Delmundo issued citations for the following deficiencies with POCs to be submitted by 8/01/23. Administrator submitted the POCs either after the deadline. failed to submit and/or POCs are incomplete. Civil penalties are assessed on this day, 8/11/23.

1. Deficiency section 87458(b)(5 ) - LIC602A Physician's Report was submitted on 8/10/23.

Civil penalty = $100.00/day x 9 days (from 8/02/23 to 8/10/23)= $900.00

2. Deficiency section 87465(f)(1 ) - L IC9020 Register of Facility Clients/Residents has not been submitted.

Civil penalty = $100.00/day x 10 days (from 8/02/23 to 8/11/23) = $1,000.00

3. Deficiency section 87303(i) - proof of purchase of signal system or call button, and picture not submitted up to this day, 8/11/23. Facility does not have working call buttons as of this day, 8/11/23.

Civil penalty = $100.00/day x 10 days (from 8/02/23 to 8/11/23) = $1,000.00 and will continue until corrected.

4. Deficiency section 1 569.695(c) - proof that disaster drills is conducted has not been submitted,

Civil penalty = $100.00/day x 10 days (from 8/02/23 to 8/11/23) = $1,000.00 and will continue until corrected.

5. Deficiency section 1569.625(b)(2) - copies of staff training submitted; however, the 8 hours required annual training was not satisfied. Administrator submitted only 2 hours training and no proof of 4 hours required postural support, restricted health conditions and hospice care training.

Civil penalty = $100.00/day x 10 days (from 8/02/23 to 8/11/23) = $1,000.00 and will continue until corrected .