Facility Evaluation Report

On this day Licensing Program Analysts (LPAs) Jenifer Tirre and Kimberly Lyman made an unannounced case management visit in conjunction with complaint visit 22-AS-20220711084817. LPAs were granted entry by staff. LPAs identified themselves and discussed purpose of the visit with Caregiver Sataporn Kitnukul. Administrator Yaninee Asawadilokchai arrived during the visit.

Upon entry into the facility, LPAs observed Staff 1 (S1) with a syringe in hand in the kitchen. S2 and S3 confirmed S1 was a new staff at the facility. S1 immediately exited the facility before LPAs could speak with the staff. LPAs inquired where S1 went and LPAs were told the staff went across the street. Present staff referred LPAs to Administrator for more information regarding status of staff. Administrator arrived during the visit and stated S1 is a friend of current staff. LPAs inquired about S1 administering medications with a syringe and Administrator denied the allegation. LPA Lyman confirmed through Regional Office that S1 does not have criminal record clearance. During medication review related to the complaint visit, LPAs observed Resident 1 (R1) and R2 have seven days of pre-poured medications in unlabeled containers. LPAs observed unsecured knives and scissors in an unsecured kitchen cabinet, a knife in a dishwasher rack and Windex unsecured under the kitchen cabinet. R3 has a diagnosis of Dementia.

Based on the observations made during today's visit, the following violations are being cited per California Code of Regulations Title 22.

An exit interview was conducted and a copy of this report along with appeal rights were left at the facility.