Facility Evaluation Report

On June 2, 2025, during the course of investigation, the department has observed multiple serious concerns about staffing, supervision, resident care, and overall facility operation during the licensee’s absence from the country. The department discovered one staff member was present and providing care, LPA spoke to a staff member on the phone, and was informed there is a third caregiver that was scheduled to show up later this afternoon. LPA observed two of the three do not have criminal record clearance. One does have criminal record clearance but is not associated to the facility. No personnel files were available for either but when a staff member arrived he showed LPA one record that is not for this facility. LPA observed the staff on duty during this visit doesn’t appear to have any training. Caregiver just admitted she has not had any training to take care of the residents. LPA couldn’t obtain access to the staff files to confirm if they staff have had any training because the administrator is not available. Resident had a fall on June 1, 2025, and facility staff didn’t seek medical attention despite the resident requesting to go. LPA observed medications are prepared seven days in advance and Title 22 regulations require medications to stay in their original container. One caregiver's first aid and CPR are expired and one does not have any.

Based on deficiencies during 10/02/2024 annual visit and complaint visit on 10/24/2024 and case management visit conducted on 10/24/2024, it shows that there is no qualified administrator operating the facility.

Deficiencies cited on the LIC 809-D, per Title 22 Regulations.

Exit interview conducted. A copy of the report has been issued. Failure to correct the deficiencies may result in Civil penalties being assessed. $1000.00 IMMEDIATE CIVIL PENALTIES ISSUED due to three staff members working with no criminal record clearance. Appeal Rights provided.