Facility Evaluation Report
On 03/29/22, Licensing Program Analyst (LPA) M. Yang conducted an unannounced case management inspection regarding incident report received from facility on 3/11/22. LPA met with caregiver Margarita Linares. Administrator Alex Babakhani and Pacita Baltazar was called and arrived shortly.
The purpose of the today's visit is to follow up on the incident report that was submitted to department on 03/11/22. Staff did not initial Medication Administration Record (Mar) on 03/02/22 after administering medication to R3. LPA interviewed staffs and reviewed records. No further action needed regarding this incident at this time.
LPA follow up on report department received regarding R3 expressed having difficult eating due to gum soreness from unfitted dentures. LPA interview staffs and resident. No further action needed regarding this incident at this time.
LPA follow up on incident report that was reported on 03/11/22. R1 did not receive medication, Calcium, as directed during bedtime in the month of February 2022. R2 did not receive Vitamin C in the evening for the month of January 2022.
Licensee reported incidents occurred on 01/01/22- 02/27/22 and 03/02/22 to department on 03/11/22.
A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 809D.
Exit Interview conducted. As a COVID-19 precautionary measure, a copy of this report and appeal rights will be provided via email. Report signed on site.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction