Facility Evaluation Report

This unannounced Case Management – Deficiencies inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of issuing citations for deficiencies observed during the investigation into Complaint Control No. 22-AS-20220323083918. LPA met with Wellness Director (WD) Maria Vasquez and explained the reason for today’s inspection.

During the course of the investigation, LPA inspected the facility, interviewed staff and residents, and obtained and reviewed copies of the resident roster, staff roster, a copy of Resident #1’s (R1) service plan marked up on January 6, 2022, and R1’s medical records.

A witness observed R1 being placed in wheelchair at the facility. LPA reviewed a copy of R1’s service plan marked up on January 6, 2022 by the facility’s wellness director at the time that corroborates a wheelchair was used for R1. However, R1’s file and R1’s medical records do not contain a doctor’s order for a wheelchair.

Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.