Facility Evaluation Report

At approximately 9:15AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1 Year Required Visit, and met with Business Office Manager, Eliana Lopez, and Health and Wellness Director, Melanie Fenn. Facility has an approved fire clearance and total capacity of 172 Non-Ambulatory Residents, where 12 can be bedridden. Facility has an approved hospice waiver for 8 individuals. Facility provides care and assistance to Older Adults in Assisted Living and Memory Care. Facility has a plan of operation for dementia care and programming on file. Upon arrival, LPA was informed that there were 14 residents in Assisted Living, 17 residents in Memory Care, 3 residents in Extended Care, and 48 Independent Living residents for a total of 82 residents in care. LPA was also informed that there were 27 staff members on-site.

LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA finished review of staff files and resident files. All files were well organized and contained the required documentation. LPA reviewed 6 resident medications. LPA observed that 1 of 6 residents had 3 medications that were not centrally stored as required (deficiency cited, regulation 87465(h)(6)). During medication review in Extended Care, LPA observed that the medication cart keys were accessible and the cart itself was unlocked and accessible to guests and residents in care (deficiency cited, 87465(h)(2)). LPA also observed that noon medications were pre-poured in Memory Care. Per discussion with Medication Technician, the noon medications were poured at around 9AM (technical violation issued, LIC9102, regulation 87465(h)(5)).

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Exit interview conducted. Copy of report, LIC809D (Deficiency Page), LIC9102 (Technical Violation/Advisories) Plan of Corrections, and Appeal Rights discussed and provided to Health and Wellness Director. Signature on form confirms receipt of documents.