Senior Care Records.

Facility Evaluation Report

Evergreen Home, Hanford09/08/2022Licence 167201075

Capacity6
Census2
Date signed09/08/2022 02:21:52 PM
The inspector’s account

On 09/8/2022, Licensing Program Analyst (LPA) K.Kaur arrived unannounced to conduct a Case Management visit. LPA introduced self, stated the purpose of the visit, and met with the Licensee/Administrator Zoria French.

The purpose of this visit is to follow up on an Incident Report that was submitted to the Fresno CCL office on 9/1/2022 regarding missed medications and medications errors.

LPA reviewed medications, MARs, and Centrally Stored Medications Logs. Based on R1 medication review medication was potentially missed or disturbed incorrectly and/ or log not marked correctly.

Deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22,

An exit interview conducted with Licensee/ Administrator. Report signed on-site and printed copy provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction