Facility Evaluation Report

Licensing Program Manager (LPM) Simon Jacob and Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Case Management – Incident visit. LPA was allowed entry into the facility by Staff Kayla Romero and met with LVN Islamdin Zainulabudin.

Today's visit was in response to a Special Incident Report (SIR), in which licensee self submitted to the CCLD San Diego Regional Office on 03/15/2024 in relation to a medication error by a designated pharmacy. The discrepancy led to a medication error by the facility.

During today’s visit, LPM and LPA toured the facility, conducted interview and collected relevant records. No deficiencies were observed or cited during today's visit. An exit interview was conducted with LVN Islamudin Zinulabuidn to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.