Facility Evaluation Report

Licensing Program Analyst (LPA) Shawna Doucette conducted an unannounced visit to follow up on a case management that occurred on 5/9/23. LPA conducted a case management to address the deficiencies. LPA met with Administrator Ramona Eleco.

LPA reviewed and obtained copies of R1's file. LPA interviewed staff and resident. After conducting interviews it was found R1 was retained with a prohibited health condition. Administrator was unable to provide documentation of a health care plan for R1. Administrator did not contact Licensing prior to R1 being released from the hospital to obtain an exception for R1. Administrator did not request an exception for R1's prohibited condition.

After conducting interviews with staff and residents it was found staff which are not skilled professionals were administering injections to R1.

On 6/5/23, R2 was admitted to facility with a restrictive health condition. Facility does not have a care plan from Home Health in the facility. LPA obtained a copy of R2's file.

Civil penalty was issued Per California Code of Regulations, Title 22, Division 6, Chapter 8, for 87616(a)(b)(1)(2) for a repeat violation and deficiencies were cited. Refer to 809D.

An exit interview was conducted and a copy of this report, plan of corrections and appeal rights were provided to Administrator Ramona Eleco