Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch conducted an unannounced visit to the facility for the purpose of documenting deficiencies observed during the initial investigation of the allegations in complaint reference #22-AS-20230217143103. LPA was greeted and granted entry by caregiving staff and spoke with administrator by telephone.

During the health and safety tour of the physical plant, LPA observed that the mounted fire extinguisher had maintenance tags dated August 2021, meaning the required maintenance is outdated by six months.

A review of resident records at the facility showed that four out of the five physician reports indicated a confirmed dementia diagnosis yet were dated by up to two years prior and were therefore outdated per the Title 22 regulations requirements.

The physician report for resident R1 indicates that upon admission, resident was healing from a Stage 3 dermal ulcer. No records of an exemption request to admit a resident with a Prohibited or Restricted Health Condition were found. A Technical Violation advisory is issued to the licensee.

LPA was able to verify administrator's Liza Mesdjian's administrator certificate is current. However, the certificates posted in facility per Title 22 regulations are shown to be outdated and related to individuals no longer associated to the facility. A Technical Assistance advisory note is issued.

Based on observation and records reviewed at the facility, two deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted via telephone and a copy of the report along with appeal rights was provided and left at the facility.