Facility Evaluation Report

On 12/08/22, while at the facility for another reason, LPA D Panlilio conducted a case management on observed deficiencies by IB investigator on 03/01/22. LPA explained the deficiencies below with administrator and the plan of corrections required.

Deficiencies observed by IB investigator on 03/01/22:

· Medication was stored in an unlocked kitchen cabinet; Medication stored inside client’s room unlocked

· Medication not stored in the prescribed bottle

· Reporting requirements – did not submit incident report for R1’s 01/24/22 unwitnessed fall

Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties .

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