Facility Evaluation Report

On 09/26/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted a Case Management visit at this facility. LPA met with caregiver Christian Espino who allowed for entry in this facility. LPA informed Espino the purpose of the visit is to conduct a health and safety check in association with the annual inspection visit conducted on 08/02/24.

In the annual inspection conducted on 08/02/24, Licensing Program Analyst (LPA) Regina Cloyd observed (2) out of the (4) residents did not occupy the proper rooms for non-ambulatory or/ambulatory. Resident #1 who is non-ambulatory was in an ambulatory room. Resident #3 is ambulatory and was in a non-ambulatory room. The facility was not compliant and was issued a citation under Title 22 Regulation 87204(b).

LPA Dabuet conducted a health and safety check and observed Resident #1 now resides in a non-ambulatory room #2. Resident #3 is no longer a resident at the facility. During the inspection, LPA Dabuet reviewed Resident #1 and Resident #2 Physician's Report LIC 602A (dated: 02/22/22 and 02/16/23). Resident #1 (R1) is non-ambulatory requires continuous bed care, is bladder/bowel impairment, and requires assistance with toileting needs. According to the LIC 500 Personnel Report (dated: 02/01/24) and staff #1's interview, no staff worked after 8:00 pm until 7:00 am. It was revealed that there are no night-shift workers at the facility to provide the services necessary to meet resident needs.

Based on observations, interviews, and record reviews, a preponderance of evidence standard has been met. The facility did not have night shift worker to provide services necessary to meet resident needs. Code of Regulations, Title 22, Division 6, and Chapter 8 are being cited on the attached LIC 809-D.

An exit interview was conducted with Christian Espino, and a hard copy of the report along with appeal rights.