Facility Evaluation Report

At approximately 10:10 AM Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a Case Management - Incident visit. LPA was greeted by staff, temperature screened before entry into the facility, and logged in to the Visitor's Log. LPA met with Angelica (Angie) Gonzalodo, Caregiver/House Manager, and informed her the purpose of today's visit was to investigate a medication error with C1 as reported via an incident report from 5/5/2024 at 3:00 PM and received by CCLD on 5/7/2024. LPA requested copies of S1's current training records, the current staffing schedule and roster, and to review the medication administration record (MAR) for C1. Licensee/Administrator, Selene Cruz-Astorga arrived shortly after and provided requested documentation including a copy of the mitigation meeting and coaching digitally signed by S1 following the incident.

At approximately 10:40 AM, LPA initiated tour of the facility with House Manager and was informed there are currently 4 clients in care, all of whom were home at the time of the visit. LPA was informed that only one client, C2, regularly attends day program. However, C2 chose to remain home today, in order to go to the DMV to apply for a new identification, as C2 has gone through the process of a legal name change.

LPA observed the facility was clean and orderly. Facility was a comfortable temperature of 70 F. Clients' rooms had all the required furnishings and LPA observed a supply of clean linens and blankets available to clients. Chemical and toxins were secured and not accessible to residents. However, LPA observed over the counter medications present in an unlocked staff cabinet in the unlocked garage which is accessed through the laundry room which was unlocked. House Manager removed the items immediately and locked them up. LPA requested Licensee/Administrator submit a statement regarding the requirement that all medications be inaccessible to clients in care, which shall be signed by all staff acknowledging their understanding. LPA advised Licensee/Administrator to lock the medications with the centrally stored medications.