Facility Evaluation Report

On 9/16/2025 at 9:00 am, Licensing Program Analysts (LPA) J. Clancy-Czuleger arrived unannounced to conduct a Case Management. LPA met with s taff Bricia Castro .

While LPA J. Clancy-Czuleger conducted a complaint investigation (15-AS-20250911100252) on 9/16/2025 , LPA was informed of or observed the following: R1 missed a medication for seven days. W1 explained that R1 returned from the hospital on 8/20/2025, the facility staff tried at that point to obtain the medication. On 8/25/25 and SIR was submitted to the department stating that "resident refused refills and refused for nurse to contact medical provider LN needs approval from client to speak to his medical providers". On 9/03/2025 this incident report was amended and that line was removed. R1's new medications were not ordered until 8/27/2025.

LPA observed while touring the facility that part of the deck trim was sticking out and not attached to the backdoor deck. This was in the emergency exit pathway. LPA observed that the exit door in R2's room was difficult to open. It was then observed that the latch strike plate of the door was not aligned correctly which may be preventing the door from opening correctly.

The deficiencies was 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.