Facility Evaluation Report

At approximately 1:10PM, Licensing Program Analysts (LPAs) Magdaleno and Felias arrived unannounced to conduct a Case Management - Annual Continuation visit and were greeted by Administrator, Pari Manouchehri. Facility has an approved fire clearance for a total capacity of 126 individuals, where 126 individuals can be Non-Ambulatory and 8 individuals can be Bedridden. Facility has an approved hospice waiver for 15 individuals. Upon arrival, LPAs were informed that there were 80 residents in care and 22 staff members on-site.

At approximately 1:15PM LPAs conducted a spot check of 8 clients files, all required documentation present. At approximately 3:00PM LPAs conducted a spot check of 6 resident medications. 1 of 6 residents were observed to have some medications not centrally stored or documented as required (technical violation issued).

Exit interview conducted with Administrator and a copy of this report was given.