Facility Evaluation Report

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Case Management visit to cite a deficiency identified during a separate visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Administrator Aleksandar Boskoski.

During the facility tour, LPA observed medications being stored in plastic containers with different sections for morning, noon, evening, and bed time. An interview with Staff #1 (S1) revealed that S1 transfers medications every morning into the corresponding time residents are suppose to receive their medication. These medications were not stored in the original medication packages. LPA explained to Administrator that medications must not be transferred into different containers in this way and in accordance with licensing guidelines must stay in their original packaging.

A deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). A Plan of Correction was jointly developed with Administrator. LPA also issued one (1) Technical Violation (TV) regarding submitting written hospice notification letters to the Department (refer to the LIC 9102-TV page).

An exit interview was conducted with Administrator Aleksandar Boskoski, to whom a copy of this report, the LIC 809-D, LIC9102-TV, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.