Facility Evaluation Report

On 6/2/22 Licensing Program Analyst (LPA) Maja Jensen arrived at the facility unannounced to conduct a case management related to medication errors as a follow up to the visit of 4/12/22. LPA Jensen met with Arneatha Simon and explained the purpose of today's visit.

LPA Jensen reviewed records including but not limited to the following records for Resident 1(R1): February/March MAR, Pre-Placement Appraisal, LIC 603, Regional Center Behavioral Support Plan and Update and Physician's Report LIC 602. LPA Jensen also interviewed the Administrator a DSP.

LPA Jensen observed the medication storage unit and confirmed that medications are locked and inaccessible to clients in care. LPA Jensen also observed a shift change narcotic count with three staff members participating.

Based on the LPA Jensen's observations, record reviews and interviews it was determined that a required medication was not administered as prescribed on 4/7/22. It was also observed that the MAR for R1 was missing initials 3/7/22, 3/11/22 and 3/20/22.

Per California Code of Regulations (CCRs) - Title 22, Division 6, the following deficiencies are being cited on the attached 809D during this visit. An immediate civil penalty is assessed in the amount of $250 for a repeat violation having occurred within 12 months, see LIC421FC.

An exit interview was conducted and a copy of appeal rights were given.