Facility Evaluation Report

On 01/26/23, Licensing Program Analyst (LPA) L. Salazar arrived at the facility unannounced to conduct a Case Management visit. LPA was greeted by staff, stated the purpose of the visit and was allowed entry into the facility. COVID precautionary measures were taken at the time of entry.

LPA is following up on a letter received 01/04/23 from the licensee. Letter was requesting an exception to retain Resident R1 from the hospital with a Prohibited Condition. Records review show R1 was admitted to the hospital with a diagnosis of a prohibited condition. R1 has not returned to facility and is currently residing in a Skilled Nursing Facility (SNF).

LPA reviewed additional facility records received at a previous visit and observed Staff S2 had been working in the facility for more than 5 days, without a Criminal Background Check/ fingerprint clearance. Staff S2 was removed from the facility schedule until a fingerprint clearance was obtained.

Based on the information received, deficiencies are being cited, per California Code of Regulations, Title 22, Division 6, Chapter 8, on the attached 809D. Immediate Civil Penalties are being assessed on the attached LIC421IM and the LIC421BG in the amount of $500, for each violation, for a total of $1000: If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal rights of resident's in care.

An exit interview was conducted with Licensee via telephone. A plan of correction was developed by licensee and reviewed with LPA via telephone. Licensee gave permission for Staff S1 (S1) to sign today's report. A copy of this report and appeal rights were discussed and provided to S1.