Facility Evaluation Report

On August 21, 2024 at approximately 11:30 AM, Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced for the purpose of conducting a Case Management-Deficiencies inspection. Upon arrival, LPA was greeted at the door by, Direct Care Staff, Tavarius Simmons, and was granted access into the facility. Administrator arrived 15 minutes later.

On July 28, 2024, the facility reported to Community Care Licensing Division (CCLD) regarding three clients not receiving the medication. The Incident Report summarizes that at 03:00 PM medications were not passed on July 28, 2024 (See LIC 809D) for three clients in care. Administrator disclosed that the facility followed-up with the Nursing Consultant of the missed medications. LPA educated the Administrator regarding the importance of advising the Primary Care Physicians moving forward as outlined in Reporting Requirements.

On August 16, 2024, the facility reported to Community Care Licensing Division (CCLD) that a client left the facility on August 16, 2024 at 06:30 AM. However, Administrator disclosed that staff was shadowing the client until the Administrator took over. Client was never left unassisted and had staff members shadowing. LPA advised that the incident report reflects a different set of events. Administrator disclosed that there was an error on the Incident Report regarding the client eloping and that moving forward the incident reports will be articulated in a more clear and concise manner. LPA educated the Administrator about Reporting Requirements as well (See LIC 9102-Technical Advisory).

Deficiencies cited from the California Code of Regulations, Title 22, Division 6, Chapter 1 of California Regulation. Appeal rights were provided. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview was conducted, and a copy of this signed report along with appeal rights were given to the Administrator.