Facility Evaluation Report

On 7/14/22 at 10:45 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a case management - incident inspection. LPA explained reason for inspection and was granted entry. LPA met with Co-Administrator Elizabeth Ramos. Licensee (LIC) Jason Johnson arrived a short time later.

CCL received a Special Incident Report (SIR) for an incident that occurred on 5/18/22. On 5/18/22, staff (S1) discovered the overflow bottle of Acetaminophe/codei 300-30 mg Qty: 90 for R1 that was filled on 5/11/22 was missing as S1 was getting ready to log the start date of the overflow bottle for the next day's administration. LIC conducted an internal investigation and could not substantiate a finding. LIC reported the incident to Bakersfield Police Department.

LPA reviewed records and conducted interviews.

A deficiency is being cited based on LPA's interviews and records review in accordance with the CCR Title 22. See LIC 809D.

Exit interview conducted. A copy of this report and appeal rights were given to Licensee Jason Johnson, whose signature confirms receipt of this report. A Plan of Correction was made with Licensee Jason Johnson.