Facility Evaluation Report

Licensing Program Analysts (LPAs) Michael Hood and Angela Hood met with Acting Administrator, Marinela "Mary" Barac, to conduct a case management visit.

During inspection conducted on 7/13/2023, LPAs reviewed medications for residents R1, R2, and R3. LPAs observed Centrally Stored Medication form to be incomplete for R2 and R3 during medication count, causing LPAs to not be able to determine if count was accurate.

Due to facility not completing Centrally Stored Medication form for two (2) residents, a deficiency is being cited pursuant to California Code of Regulations, Title 22, Section 87465(a)(4) regarding medication administration. Deficiency is listed on 809-D.

Exit interview was conducted with Acting Administrator. A copy of this report and appeal rights were provided. The Acting Administrator’s signature on these forms acknowledges receipt of these documents.