Facility Evaluation Report
On 05/09/25, Licensing Program Analyst (LPA) M. Yang conducted an unannounced case management deficiency inspection regarding incident reports that received from the facility. LPA met with Administrator Karen Dhaliwal and Licensed Vocational Nurse Diane Cramer.
The purpose of the today's visit is to address a medication error. Facility reported medication checked was completed on 04/18/25 at 10:00PM, S1 inadvertently administered R1’s medication Hydrocodone-Acetaminophen 5mg-325mg to R2 on 04/18/15 at approximately 08:41PM. On 04/18/25 at approximately 03:30PM, S1 inadvertently administered R3’s medication Oxycodone-Acetaminophen 10mg-325mg to R4.
A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 809D. A
civil penalty is being assessed see attached Lic 421IM.
Exit Interview conducted. A copy of this report and appeal rights was provided to Administrator, whose
signature confirms receipt of this report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction