Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon conducted a Case Management (CM)- Deficiencies visit to the facility above. LPA met with Administrator Kathyrine Valdez and explained the purpose of the visit.

Community Care Licensing (CCL) received complaint # 29-AS-20220202105403 on 02/02/2022 and during the complaint investigation deficiencies were observed these deficiencies did not relate to the complaint allegations and therefore are being addressed on this CM visit.

CCL Investigation Branch conducted the investigation. During the physical plant tour on 02/14/2022 Investigator Munoz observed the following deficiencies: During the physical plant tour the investigator took photos of the resident 1 (R1's) bedroom. Photographs show a baby monitor in the resident’s room. Staff interviews also confirmed they use baby monitors for the residents. LPA De Leon spoke with Staff at the facility and explained that baby monitors are a personal rights violation and if the facility wanted a device for residents to get help, they must comply with the regulation requirements. Staff removed baby monitors from the resident’s room and will work with corporation to provide something to residents that met the regulation requirements. During the investigation facility records were reviewed and the following were noted by the Investigator: Resident #1 (R1) has SIB and uses bi-lateral arm splints with a Dr. order dated 10/11/2018. LPA De Leon reviewed the facility record and CCL does not have an approved exception for R1 on file for the use of these on R1. The documentation reviewed for R1 shows a physician report LIC 602A dated 11/30/2021 stating R1 is total care . LPA De Leon reviewed the facility record and CCL does not have an approved exception on file for the total care of R1.

Exit interview conducted, deficiencies cited, copy of report and appeal rights emailed to the Administrator/Licensee.