Facility Evaluation Report

On 12/9/21, Licensing Program Analysts (LPAs) K. Kaur and S. Doucette arrived at the facility unannounced to conduct a Health & Safety inspection to review newly admitted resident records.

LPA's reviewed resident file, which did not have a LIC602 Physicians Report. LPA's reviewed residents medications and records which did not show medications were given to R1 for 12/9/21. LPAs obtained original License that had previous permissions from Licensee. The most current License was posted in the facility.

LPA's toured the facility and checked on residents in care. During the tour of the facility, LPA observed the stove knobs to be on the stove and accessible to residents in care. Facility has a two day supply of perishable food and a 7 day supply of nonperishable foods.

Based on interviews conducted, tour of facility and records review, deficiencies are being issued in the areas evaluated and listed on the 809-D according to California Code of Regulations Title 22, Division 6 and Health and Safety Code.

An exit interview was conducted and Plan of Correction was reviewed and developed with the Licensee. Licensee was provided with a copy of this report and Appeal Rights via email.