Facility Evaluation Report

While conducting investigation of a complaint (Complaint Control # 15-AS-20240627081442), Licensing Program Analyst (LPA) Delmundo learned, obtained information and observed the following:

1. Staff (S1) who has fingerprint clearance on file is not associated to this facility.

2. Residents LIC622 Centrally Stored Medication and Destruction Records do not have dates medications were started.

3. Some of resident's (R1) medications and all of resident (R2) medications do not have doctor's order on file,

Deficiencies are cited from Title 22 California Code of Regulations, and listed on 809Ds. Failure to submit proof of corrections by plan of correction due dates and any repeat violation within 12 month period may result in civil penalties.

Deficiencies and plan and proof of corrections were discussed with the licensee and administrator.

Exit interview conducted. Appeal Rights. LIC9098 Proof of Correction form, and copy of this report provided.