Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a Case Management visit on 2/6/23 at 2:30pm. LPA met with Sharmila Singh and stated the purpose of the visit. LPA requested to see the Medication Record in which Regional Center deemed a deficiency of medication error on 10/6/22 that was cleared on 10/19/22. LPA observed the Medication Administration Record (MAR) for resident #1 and the training provided to staff for MAR use and medication training.

Administrator confirmed that the errors occurred. The MARs was not completed correctly as she was transferring the medications from one log to the other. The medications for resident #1 were not missed but discontinued by the doctor before the resident moved into the home. However, the medication remained on the medication list.

The Administrator has since then updated the MAR by removing discontinued medications, ensured prescriptions usage frequency are on medications, ensured all medications if possible are in bubble packs, and medications are locked at all times when not in use.

The Administrator conducted in-service training for staff regarding medication management and record keeping on 12/5/22 and 1/6/23.

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. An exit interview was conducted, a copy of the report was given.