Facility Evaluation Report

On 02/04/2026 at 9:15 AM, Licensing Program Analyst (LPA) P. Manalo conducted an unannounced Case Management visit regarding an incident that was reported to CCLD on 01/23/2026. LPA met with Administrator (ADM), Julie Secretario, and explained the purpose of the visit.

Incident report indicated that on 01/22/2026, C1's medication was not provided by the night shift staff at 6:30 AM and was given to C1 later.

During the visit, LPA reviewed C1’s, Medication Administration Record (MAR), physician report, doctor’s order for the medication, LIC500, client roster, and staff training.

Interview with ADM revealed that S1 told ADM that S1 provided another medication to C1 instead of the 6:30 AM dosage. ADM stated that ADM noticed that the medication was not provided yet since it was still in the bubble pack. However, the MAR was filled out for both medications by S1. Interview with S1 confirmed that S1 gave the wrong medication to C1 and signed the MAR. Later, S1 stated that S1 signed for the medication that S1 signed for both of the medications.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties.

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