Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management visit and met with Administrator (ADM) Marina Sampani. The purpose of the visit was to respond to a report that there were no staff working at the facility.

LPA Marrufo arrived at the facility at 3:00 PM and observed ADM Sampani speaking with witness W1. W1 stated to have arrived at the facility at 1:45 PM and was greeted by a resident. W1 stated the resident told W1 that the only staff at the facility was napping and there were no other staff at the facility. W1 then called 911. ADM told LPA that when ADM observed police arrive at the facility, ADM came to the front of the house and met with W1.

LPA Marrufo toured the facility and interviewed staff, residents, and ADM. ADM stated that the door is not to be used by visitors and visitors should instead use the sliding door at the kitchen. LPA Marrufo did not observe any signs directing visitors to use the sliding kitchen door. LPA Marrufo observed that the doorbell at the front door did not work. LPA Marrufo observed that the kitchen telephone had a faint sound and disconnected once it was picked up. LPA Marrufo observed a second land line telephone in the common area. The second land line did not make a sound when called. LPA Marrufo observed a bedroom in the facility that had resident R1 sleeping in one bed and staff S1 sleeping in the other. R1 stated that S1 sleeps in that bed overnight and naps in the bed during the day. S1 stated to have been napping earlier in the day. S1 stated to be hard of hearing and LPA observed S1 to be wearing a hearing aid. S1 stated to not be able to hear the kitchen land line telephone from the bedroom area, but is able to hear it if S1 is in the dinning room.

An LIC9102 Advisory Note was issued. Deficiencies were cited as per California Code of Regulations Title 22. See LIC809-D for more information. This report was reviewed with ADM Sampani and a copy of the report and appeal rights were provided.