Facility Evaluation Report

Licensing Program Analyst(LPA) Christine Yee conducted a case management visit due to the deficiencies observed during a visit to the facility today. LPA Yee met with Eva Elizalde, Staff. Also present during the visit was Viktorya Hayrapetyan, Consultant. The reason for today's visit was explained.

The following deficiencies were observed on today's visit:

Per review of Resident #1's file, it was observed that the PRN Authorization letter for PRN medications - Nitroglycerin .4 mgs and Acetominophen 500mg was incomplete. The PRN Authorization letter does not state if the prescribing doctor has determined that resident is able to determine his/her need for prescription and non-prescription medication on a PRN basis it does not list the PRN medications prescribed to resident and is not signed by the doctor.

The facility does not retain copies of the physician's order for all the residents centrally stored medications.

The Licensee did not report Resident #1's, 911 calls for service and on 12/14/24, 12/27/24, 1/3/25 and 1/8/25 and the 911 call and hospitalization on 12/18/24 - 12/22/24. A copy of the LIC624- Usual Incident/Injury Report was provided for 12/14/24 and 1/8/25 for the 911 calls and was supposedly mailed to Woodland Hills office. Licensee was unable to provide evidence of the mailing.

Deficiencies were cited under California Code of Regulations, Title 22, Division 6, Chapter 8.

Eva Elizalde, Staff left the facility around 3:15pm due to a family emergency and Viktorya Hayrapetyan, Consultant left around 3:42pm .

Exit interview was conducted with Flora Galoyan, Staff, as authorized by Eva Elizalde.