Facility Evaluation Report

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to this facility to follow up regarding a previous inspection visit of 10/10/23, where LPA requested facility have resident R1 medically assessed to determine ambulatory status.

Resident R1's Physician Report in file, dated, 6/15/2023 does not indicate R1s ambulatory status. Prior Physician report for R1 dated 2/23/2022 indicates R1 as Non-ambulatory, but there is a question regarding R1s current ambulatory status and LPA had requested facility to have R1 medically assessed with a medical report completed in full. LPA once again went over requirements for facility to submit paperwork to Community Licensing regarding a request for bedridden room review.

In addition LPA found staff present in the facility S1, who was fingerprinted but has not received proper clearance to the facility. LPA went over requirements and a civil penalty was assessed for $100.00 for staff S1.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.