Facility Evaluation Report

On 10/26/2023, Licensing Program Analyst (LPA) arrived unannounced to conduct an annual continuation inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA was granted entry to the facility and facility staff contacted Assistant Administrator, Diana Diaz. LPA met wit h Assistant Administrator, Diana Diaz.

During today's visit, LPA reviewed medications and conducted a facility tour. Upon review of medications, LPA observed the following: From 07/16/23 – 07/20/23, R1 did not receive the prescribed medication, Quetiapine Fumarat 300MG records indicated that there were "none to give". On 07/07/23, R2 was out of Namzaric 14-10M, and from 08/26/23 – 08/27/2023 R2 was out of Miratazapine. On 07/08/2023, R3 was out of Vitamin D3 and on 08/31/2023, R3 was out of Divalproex. On 07/11/2023, R5 was out of the medication Levetiracetam. There were multiple dates in July 2023 and August 2023, when R6 was out of Mirtazapine. From 08/20/2023 through 08/21/2023, R6 was out of Oxybutynin.

During the period 07/01/2023 through 08/31/2023, there were multiple incidents of residents refusing medications, however the Licensee did not furnish a report to notify Fresno CCLD of the resident's refusal.

During the facility tour, LPA observed that the Licensee did not maintain the original fire clearance that was approved by the fire department, when a room cleared for use as a living room, based on the original facility sketch on record, was being utilized as a resident bedroom. Administrator, Jason Johnson was contacted via telephone, Administrator confirmed that "some modifications" had been done to add a door to the room identified as a living room and a portable closet was placed in the room to satisfy CCLD requirements.

Deficiencies are being issued in accordance to California Code of Regulations, Title 22, Division 6 on the attached 809D. An immediate civil penalty in the amount of $500 is being assessed for issues related to fire clearance.

Exit interview conducted and a plan of correction was reviewed and developed. A copy of this report, civil penalty, and appeal rights were discussed and provided to Assistant Administrator, Diana Diaz, whose signature on this form confirms receipt of these documents.