Facility Evaluation Report

On 8/2/22 at approximately 1:00pm Licensing Program Analysts (LPA) Maja Jensen and Ruth Wallace arrived at facility unannounced to conduct a case management visit. LPAs Jensen and Wallace met with Administrator Arneatha Simon and explained the purpose of today's visit.

The facility self reported a repeat medication error as having occurred with resident 1 (R1). LPAs Jensen and Wallace interviewed Administrator Simon who confirmed that medication errors in the form of missed medication doses have occurred with staff 1 (S1). The Administrator also confirmed that personnel action was pursued and S1 is no longer at the facility.

LPAs Jensen and Wallace reviewed the Medication Administration Records (MARs) for R1 and verified the medication errors did occur over the course of the past year. LPAs also discussed the medication training protocols with the Administrator. The Limited Liability Corporation (LLC) has 3 Licensed Vocational Nurses (LVNs) on staff for this facility, direct care staff and Administrator for oversight of medication passes. Initial medication training and follow up in-service training is conducted with all employees as needed for the facility.

Per California Code of Regulations (CCRs) - Title 22, Division 6, the following deficiency is being cited on the attached 809D during this visit.

An exit interview was conducted and a copy of this report, appeal rights and a copy of the confidential names list were given to the Administrator.