Facility Evaluation Report

At 8:30am, Licensing Program Analysts (LPAs) Sandra Urena and Salia Walker conducted an unannounced Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint control # 29-AS-20210902165549). Upon arrival, LPAs were greeted at the door by Activities Director Ulka Sanghaui. The LPAs met with Administrator Melissa Christopher at approximately 09:00 a.m. and explained the reason for the visit.

During today’s visit, the LPAs reviewed files for twenty (20) out of thirty (30) residents between 08:30 a.m. and 04:00 p.m. Resident files were reviewed for admission agreements, medical assessments, appraisals, consent forms and medication records. Upon review of residents' files, it was observed that twenty (20) out of twenty (20) residents did not have an LIC 603A Re-appraisal nor an updated LIC 625. Therefore, based on records reviewed the following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. Signatures obtained. A copy of the report and appeal rights were provided.