Senior Care Records.

Facility Evaluation Report

Southland Home, Nipomo02/26/2023Licence 405802555

Capacity4
Census4
Date signed02/26/2023 02:30:41 PM
The inspector’s account

LPA De Leon conducted a Case management- deficiency visit to the facility above on 02/26/2023 at 1:15 pm. LPA met with Nereida Leal and explained the purpose of the visit.

LPA conducted an audit on 02/01/2023 of the facilities P&I funds for R1 during a complaint investigation # 29-AS-20230125120415 in which some deficiencies were found that did not pertain to the complaint allegation and are being addressed on this case management visit.

The facility provided LPA a copy of R1’s LIC 405 Record of Residents Safeguarded Cash Resources and a handwritten ledger of funds used for movie tickets. The receipts were not provided for these transactions of $3.95 for movie tickets. R1’s Resident Fund Management Service (RFMS) statement was reviewed and not all receipts for debits listed were provided. The statement and balances were accurate on these forms but not all receipts were provided. The staff interview revealed the facility does not keep any P&I funds at the facility and they are kept at the business office in San Luis Obispo, CA. The facility had to request the records from the business office to provide to LPA. The facility must provide the receipts to the business office which in turn provides them to the corporate office and if the Administrator or facility want a copy of any of the receipts, they must request a copy from the corporate office. The property purchased on R1’s RFMS statement between 07/26/2019-03/22/2022 was not all listed on the LIC 621 Resident Personal Property and Valuables Statement. Administrator did update the form and listed all property for R1 and provided a copy of the up-to-date LIC 621 to LPA by email later that day. The audit did not reveal any misuse of R1’s funds but it did reveal regulation deficiencies on record keeping of receipts and providing the LPA the requested records upon demand during normal business hours.

Exit interview conducted, deficiencies cited, copy of report and appeal rights printed and left with Staff. Emailed copy of report to Administrator.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction