Facility Evaluation Report

On 1-16-24 at 1:45pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit regarding incident reports dated 10/7/24 and 11/5/24. LPA met with Administrator Rosaaurora Nguyen and explained the purpose of the visit. LPA conducted brief interview with resident1 (R1), Administrator, and staff1 (S1). LPA also reviewed facility file documentation including individualized program plan (IPP) for resident1 (R1), physician's report for R1, and medication records for R2.

Incident #1: On 11-5-24, Licensee reported that R1 disclosed that she had a described inappropriate interaction with another individual while on an outing 11/1/2024. Based on the nature of the interaction, Licensee reported incident to Licensing department and local law enforcement within appropriate regulatory time frames. Further review of R1's records revealed R1 is able to leave facility unassisted and Licensee was aware of R1's whereabouts.

Incident #2: On 10-7-24, Licensee reported that R2 was given medication at the incorrect time on 10-4-24 by S1. LPA reviewed medication log sheets to verify accuracy of medications and determined physician's orders matched medication log sheets. Licensee notified licensing department and R2's responsible party within regulatory time frames. Based on interview conducted it was revealed that R2 did not experience complications as a result of the medication error. LPA verified completed medication training for R2.

As a result of today's case management, citation is issued under Title 22, Division 6. An exit interview was conducted with Administrator and a copy of this report was provided. Appeal rights provided.