Facility Evaluation Report

Licensing Program Analysts (LPAs) Vincent Moleski and Holly Williams arrived unannounced to conduct a case management visit. LPAs Moleski and Williams met with facility administrator Eric Serrano and explained the purpose of the visit.

LPAs Moleski and Williams reviewed facility files and obtained copies of resident records pertaining to five residents (R1-R5).

Two residents diagnosed with dementia (R1, R3) had LIC 602s on file with exam dates more than one year in the past. R1's LIC 602 indicated that R1 was examined by a physician on 4/3/23. R1 has dementia, according to the LIC 602. R3's LIC 602 indicated that R3 was examined by a physician on 9/27/22. R3 has dementia, according to the LIC 602.

Serrano could not produce a more recent LIC 602 for either of these residents during this visit.

This facility is hereby cited per 22 CCR Section 87705(c)(5). An exit interview was held with Serrano. Appeal rights and a copy of this report was left with Serrano.