Facility Evaluation Report
On 5/21/2024 at 1:00pm Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct a Case Management visit. LPA met with Administrator, Ding Wang, and explained the purpose of the visit.
While LPA L. Hall was conducting a complaint investigation ( 15-AS-20240513172348 ) on 5/21/2024. LPA requested R1's file for review and S1 stated someone took R1's binder.
The following deficiencies were observed during visit.
LPA observed R1's binder was not available for review.
LPA observed S1 did not submit death report for R1.
LPA observed each resident MAR (Medication Administrative Record) was not accurate.
Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (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. A copy of this report and appeal rights provided
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction