Facility Evaluation Report

On 2/22/24, Licensing Program Analyst (LPA) Grace Donato conducted an unannounced case management visit. LPA met with Caregivers Aljolyn Maquiddang & Susie Herrera then Administrator Rick Aban followed after. LPA explained the purpose of the visit.

LPA toured the facility, and it was observed there is not enough food supply when the current census is six. There is not enough canned food and non-perishable foods.

LPA also observed that a new resident (R1) doesn't have a the required paperwork. It was however produced when LPA asked for documentation. LPA interviewed a staff (S1) and it was mentioned that they are not aware about the health issues that R1 has. They were just informed that the facility will have a move in.

LPA checked the Medication Administration Records (MAR) for R1 and there was documentation.

Deficiencies are cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report was discussed and a copy of this report and the Appeal Rights are provided.

This report was reviewed with and a copy of the report and appeal rights was provided.