Facility Evaluation Report

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced visit in order to conduct a health and safety check due to an incident that happened at the facility. LPA met with Program Director, Jossye Cook who was informed of the purpose of the visit.

LPA conducted a walk through of the interior and exterior of the facility. LPA observed the facilities food supply which was within the 2-day perishable and 7-day non-perishable food items. LPA observed the facility residents that were in the front patio, in their rooms, dining room, and hallways. LPA walked through the kitchen, facility hallways, facility laundry room, and resident rooms and bathrooms. LPA observed Resident #1 (R1)'s room who was involved in the incident. LPA also walked and took pictures of the restroom where the incident occurred. LPA collected documents from the resident's file, facility documents and obtained a summary of events that transpired. The facility will send the department the coroner's report and the death certificate when it becomes available.

LPA reviewed the LIC500 for staff and found that (6) staff were not transferred from Licensee's other facility Roy's Desert Springs Adult Residential Care. LPA checked for Staff #1 (S1), social and date of birth and found that the employee is not in the background check database, LPA will issue a deficiency for S1. This will be document on an LIC809-D page along with the plan of correction. LPA will document Technical advisory note for staff that have not been transferred. Program Director stated this can be completed by Wednesday 11/9/2022. The facility will be issued a civil penalty in the amount of $500 for the uncleared staff.

An exit interview was conducted where this report was reviewed, along with LIC809-D page and appeal rights, and was provided to Program Director, Jossye Cook.