Facility Evaluation Report

Licensing Program Analysts (LPAs) Simi Rai and Steve Chang arrived to the facility unannounced to conduct a case management visit to follow up on resident (R1) who was admitted after the previous facility was closed due to TSO (Temporary Suspension Order). LPAs met with staff (S1) Noemi Velasquez.

LPAs spoke with Licensee/Administrator (ADM) Tingiu Li over the phone and stated the purpose of today's visit. LPAs obtained verbal permission from ADM for S1 to sign today's report on ADM's behalf.

LPAs toured R1's room and observed bed with available bedding, a night stand and functioning lights. LPAs observed a bathroom which had a working toilet, sink and functioning lights.

LPAs toured the kitchen and pantry closet to observed 2 days of perishable foods and 7 days of nonperishable foods.

The facility staff is working with R1's responsible party and R1's physicians to obtain the necessary required documents for R1's file. The facility staff is continuing to monitor and assess the resident to ensure the appropriate care and supervision is provided to R1.

During visit, LPAs observed a bar cart in front of the staff rooms which is located at the entrance of the sun room. The bar cart had over 6 bottles of alcohol which was accessible to residents. Based on review of resident's Physician's Report, resident is diagnosed with dementia. Staff S1 removed the alcohol bottles from the bar cart and placed them in the locked staff room. LPAs spoke with Licensee/Administrator (ADM) Tingiu Li in regards to Title 22 regulations and ADM stated she will ensure the bottles of alcohol are inaccessible to the residents with dementia. ADM agreed and understood.

Deficiencies were cited per California Code of Regulations, Title 22, please see LIC 809-D. LPA Rai spoke with ADM over the phone and conducted an exit interview. This report was reviewed with Staff (S1) Noemi Velasquez and a copy of the report was provided. Appeal Rights were provided.