Facility Evaluation Report

Licensing Program Analyst ( LPA ) Talwinder Bains conducted a case management visit to this facility on 05/15/25. LPA met with Administrator Angelina Romena and explained the purpose of today's visit.

The purpose of today's visit is to follow up Title 17 reviews conducted at this facility by Alta California Regional Center (ACRC) on 04/01/25. Facility Action Report (FAR) was generated by ACRC from the Title 17 reviews. Community Care Licensing Division (CCLD) received a copy of the FAR and it was noted in the FAR the facility was cited for violations that are in both Title 17 and Title 22. The visit today is to address the issues found in the FAR that apply to Title 22.

Based on the FAR report, the facility violated the following Title 22 violations:

· Hydrocortisone, Mupirocin, and Acetaminophen has no PRN form.

· Risperidone dosage does not match Rx prescription on CSMDR.

· Lorazepam PRN medication is missing from the facility.

· Missing signature for Lorazepam for medication administration on 4/1/25.

· Senna 8.6 mg is missing from PRN authorization letter.

· Melatonin 3 mg is the current Rx prescription but PRN authorization letter states 1 mg.

· Staff, S1, First Aid was found expired on 04/01/25

· Staff, S2, has not completed 12 CE units within the 12 months from date of hire. Per Facility Plan of Operation, "the Administrator shall conduct monthly in-service training's in the home”.

· S2 has missing certificates for monthly in-service training's.

Based on the above, deficiencies are cited pursuant to California Code of Regulations, Title 22 and documented on the attached LIC809D. Exit interview conducted and copy of report ,LIC809G and appeal rights provided.