Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a case management visit on 4/16/24 at 8:45am. LPA met with Carmenchita Tejada and stated the purpose of the visit. LPA interviewed Carmenchita Tejada and Staff #1 (S1) regarding a records error on medication that was found during an Alta Regional Center visit. S1 indicated that during the administration of medication, the visit occurred and 1 box of the MARs was missing an initial indicating the resident received the medication. Both stated the medication was not missed as it would be indicated when resident #1 (R1) would have a behavior.

LPA also observed training certificates (CEUs) taken by both Carmenchita Tejada and Clifford Tejada for the year of 2022-2023 which will be submitted to Regional Center as proof that classes were completed during that year.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, the following deficiencies are being cited on the attached 809D during this visit.

If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed.

The Administrator was provided a copy of their rights (LIC9058) and their signature on this form acknowledges receipt of these rights.

Exit Interview held and a copy was provided.