Facility Evaluation Report

On 8-29-23 at 2:33pm, Licensing Program Analysts (LPAs) Michael Bilger and Arvin Villanueva arrived unannounced to conduct a case management visit regarding reported medication errors. LPAs met with facility manager Ryiesha Levingston and explained the purpose of the visit. LPAs reviewed incident reports dated 8/14/23 and 8/24/23 and conducted a brief interview with facility manager.

Incident #1: On 8-14-23, facility reported to licensing department that an extra dose of Cetirizine medication was given to resident1 (R1) at approximately 8am. This incident occurred on 8-14-23 and reported to R1's physician as well. No adverse side effects were observed by facility staff.

Incident #2: On 8-24-23, facility reported to licensing department that resident2 (R2) was administered an 8:00pm Divalproex medication at 8:00am. This incident occurred on 8-22-23. Facility notified nursing team and monitored for side effects. No adverse side effects were observed by facility staff and R2's physician was notified.

Above incidents were reported to licensing department within regulatory required time frames. Additional medication staff training has since been completed regarding the above incidents.

As a result of today's case management, citations are issued under Title 22, Division 6. A civil penalty in amount of $250 is issued due to repeat violation within a 12-month period. An exit interview was conducted with facility manager and copy of this report was provided to facility manager. Appeal rights provided.