Facility Evaluation Report

On 5/4/22 at 1:30pm Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced case management inspection to address deficiencies observed while at the facility for an unrelated complaint investigation.

LPA arrived at the facility and looked into the facility from the front window. LPA observed Staff member not wearing a mask and quickly dawn a mask when she opened the door and observed LPA was at the door. When LPA entered the facility LPA observed three visitors in the living room visiting with a resident. All were not wearing masks. LPA informed Administrator of LPAs observations and administrator provided masks to the visitors who all dawned them without comment or complaint. .

Additionally, LPA conducted file review of the program statement and plan of operation for the facility at the program office. LPA observed the plan of operation to state: "All medications will be self administered, recorded and given per physician's orders". During a previous inspection LPA attempted to review medication logs and was informed by Licensee that the facility was not documenting medication administration. Licensee has resumed medication documentation per the plan of operation.

The following deficiencies are cited per California Code Regulation, TITLE 22.

Exit interview was conducted with the facility administrator. Appeal Rights were issued, and a copy of this report was left at the facility.