Facility Evaluation Report

Licensing Program Analysts (LPAs) Armando Perez and Robert Campbell conducted an unannounced visit to the facility for the purpose of issuing citations for deficiencies observed during an unrelated incident. LPA met with Caregiver Edith Campos.

During record review, LPA noted that Resident #1 (R1) had been admitted to the facility with a restricted health condition. Further findings indicated that R1 was not enrolled in hospice care and no exception for admitting resident with restricted health plan had been submitted to the Community Care Licensing Division. In addition, R1 had a consistent history of refusing medication and declined staff assistance with monitoring requirements.

During an interview with Licensee, Ma Satchel Lecita (L1) stated they relied on R1’s History and Physical Report from his last hospitalization. Additionally, L1 stated R1 did not want to answer many questions during initial assessment. L1 stated R1 did confirm he was diagnosed with a restricted health condition but could manage their own medications.

Based on record review and interviews, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809-D.

An exit interview was conducted and a copy of this report, 809-D and Appeal Rights was discussed with and provided to facility representative. .