Facility Evaluation Report

Licensing Program Analysts (LPAs) Leslie Ngo-Castaneda and Nadia Shahbazian met with facility designee Armine Kiseleva for a Plan Of Correction (POC) visit.

The purpose of the POC visit is to make sure deficiencies were corrected on reports issued on 10.23.2024

At 12:45PM LPAs toured the home and requested the following:

-CCR 874659(c)(3) Incidental Medical and Dental Care Services:

POC: Based on record review, the licensee did not comply with the section cited above in 1 count out of 1 PRN medications were not documents in CSMDR which poses/posed a potential health, safety.

POC date 10.8.2024: All supplements and PRN medications is documented in CSMDR.

For todays visit 11.18.2024, LPAs saw a repeat violation that was cleared on 10.23.2024. Therefore, an immediate civil penalty is issued for failure to correct the violation, and a new LIC 809-D is created with a new Plan of correction (POC) date. Administrator was contacted and LPA was informed that all required documents will be submitted promptly.

Exit interview conducted, appeal rights given and a copy of this report signed and delivered.