Facility Evaluation Report

Licensing Program Analyst (LPA) Trevor Byrne arrived to the facility to conduct an unannounced Case Management- Deficiencies inspection.

During record review LPA observed Resident #1’s (R1) file. R1’s file was observed to contain an incomplete hospice care plan. Resident #2’s (R2) file was observed to contain blank pre-placement appraisal information, appraisal needs and services plan, and client personal property and valuables sheets. Additionally, R2’s file was missing a physician’s report. Resident #3’s (R3) file was observed to have an admission date of 09/25/2024 and a physician’s report dated 01/12/2023 which is outside of the required 12-month timeframe required prior to admission. Interviews with the facility Administrator revealed that they charge resident’s additional fees for requested snacks that are not normally available on the facility’s menu. The facility’s admission agreement states, “If requested, special food products purchased for an individual resident will be itemized on a monthly statement and charged at facility’s cost.” The Administrator stated that they have not provided resident’s representatives with an itemized receipt for these purchases.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies was cited (refer to LIC 809-Ds): Exit interview conducted and copy of the report was issued and appeal rights provided.