Facility Evaluation Report

On 09/19/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a case management visit. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Alexis Rutledge.

The purpose of this visit is to follow up on an incidents that occurred at the above facility on 08/07/2023 and 08/18/2023.

The facility reported that on 08/07/2023 at approximately 4:00PM, facility staff did not asisst C3 with self-administration of a prescribed medication. Per Administrator, facility staff did not administer the 400mg Acyclovir during the 4:00PM medication pass to C3 resulting in C3 missing the medication.

The facility reported that on 08/18/2023 at approximately 2:48AM, C1 entered C2's room and put genitals in C2's face. Facility staff failed to provide 1:1 supervision to C1 and C2 as evidenced by staff not intervening to stop the incident from occurring.

Deficiencies are being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. A civil penalty in the amount of $250 is being assessed for repeat violation.

Exit interview conducted. A copy of this report, civil penalty, and appeal rights were discussed and provided to Administrator, Alexis Rutledge, via email due to technical issues. Report was signed on site by Administrator.