Facility Evaluation Report
On 02/11/2026, Licensing Program Analyst (LPA) Gorban conducted an unannounced case management deficiency inspection regarding incident reports that received from the facility. LPA met with Dora Rodriguez.
The purpose of the today's visit is to address a medication error. Facility reported medication error that occurred on 11/23/25 at 08:15 AM, C1 received medications twice: Escitalopram Oxalate 20 mg.
Per incident report, prescribed physician was notified, no side effects observed/ recorded. Medication error incident was not addressed at the time due to facility was working with Technical Support Program.
A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached LIC 809D in the area of Health related Services . A civil penalty is being assessed see attached LIC 421IM Repeat.
Exit Interview conducted. A copy of this report and appeal rights was provided to Administrator, whose
signature confirms receipt of this report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction