Facility Evaluation Report

Licensing Program Analysts ( LPA s) Rosaura Valenzuela, Leslie Ngo-Castaneda and Licensing Program Manager Naira Margaryan conducted an unannounced Case Management Visit to the facility and met with the Interim Administrator. LPA informed him that the purpose of this visit was to issue the citations and civil penalties for the deficiencies observed during the Licensing Visit.

The following deficiencies were noted at the time of this Case Management Visit:

Operating out of scope- Upon file review it as noted that facility is Implementing an "Independent Living Plus" program without having obtained prior approval from the Licensing Department

Improper placement of residents- It was observed that non-ambulatory residents are being housed on the second and third floors.

Fire clearance upon review of facility file LPAs and LPM received the following information; facility does not have approved fire clearance for non-ambulatory residents to reside on the second floor.

No updated physician's report-Upon file review, it was noted that residents physician's reports and needs and services plan are not being updated as needed.

Per the California Code of Regulations (CCR), Title 22, Division 6, Chapter 8, the following deficiencies were observed and cited (Refer to LIC 809-D).

Exit interview conducted and a copy of the report was issued.