Facility Evaluation Report

At approximately 9:45AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct a case management visit to follow up on two incident reports submitted by the facility. LPA met with Executive Director Alma Peralta and reviewed records.

On 04/20/2026, staff, S1, assisted resident, R1, with medications. S1 gave R1 a medication that was supposed to be held in preparation of an upcoming medical procedure. S1 failed to verify medications before giving them to the resident. S1 caught the error and made the proper notifications. R1 was observed for changes and was fine. S1 was provided additional training and left employment at the facility.

On 06/07/2026, staff, S2, was assisting residents with medications and accidentally gave resident, R2, another residents pill. The error was caught during the change of shift medication count. All notifications were made and R2 was observed for side effects with none occurring. S2 received refresher training to ensure future errors do not occur.

This is a repeat violation in a 12 month period. An immediate civil penalty is being issued in the amount of $250.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Alma Peralta and Appeal rights were given.