Facility Evaluation Report

On 12/17/2024 at 10:20 AM Licensing Program Analysts (LPAs) L. Alexander and K. Nguyen arrived unannounced to conduct a Case Management visit. LPAs met with Caregivers, Paciencia, Winnie and Cesar. House Manager, Jezrael Pascual , arrived approximately, 1 hour later. Administrator, Victoria Puruganan was not available.

While LPA L. Alexander and K. Nguyen was conducting a complaint investigation(15-AS-20241213161313) on 12/17/2024. During record review LPAs observed Resident (R) R1 and R2 did not have a current annual medical assessment and Appraisal Needs and Services (ANS) within the last year. Staff stated that R1 was admitted to hospice care on 12/10/2024 and there were no updated ANS documenting change of conditions. LPAs observed that R3 who has a diagnosis of Dementia does not have an updated ANS on file.

LPAs obtained the following documents: admission agreement and hospice care admission for R1 and Physician's Report for R4.

The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalties.

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