Senior Care Records.

Facility Evaluation Report

Frederickson Home II, Elk Grove08/06/2024Licence 342701120

Capacity6
Census4
Date signed08/06/2024 04:18:20 PM
The inspector’s account

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a case management visit. LPA Valerio met with facility staff Rose, and explained the purpose of the visit. Facility staff contacted Administrator Valerie via cell phone. LPA Valerio read the report via cell phone. Administrator Valerie designated facility staff Susan to sign on her behalf.

LPA Valerio received a Facility Action Report (FAR) from Alta California Regional Center (ACRC) dated 07/01/2024. The facility was under a corrective action plan with ACRC due to a medication error discovered on 06/17/2024. ACRC found that Resident 1 (R1) was ordered to received calcium 600 mg PO, however, the facility was providing R1 with calcium 500mg PO. FAR dated 07/01/2024 stated that the facility developed a written protocol to ensure clients are receiving the medication as prescribes, conducted an in-service training on the protocol, and submit an incident report for the medication error.

Per California Code of Regulations (CCR) – Title 22, deficiencies are being cited on the attached LIC 809 – D page. An exit interview was held, and a copy of the report was provided to facility staff Susan. Appeal rights were provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction