Facility Evaluation Report

License Program Analyst's (LPA) Shannan Hansen arrived at 10:30 AM to complete an unannounced annual inspection and met with Douglas Cattich, Licensee/Administrator. There is a total of 9 residents.

LPA reviewed centrally stored medication record, and finished tour of facility to complete this annual inspection

The Medications of 2 out of 2 residents were found to be given according to physicians’ directions on 7/13/2023 at 10:55 AM. However, residents medications have been 24 hour pre-poured and new regulation 87465(h)(5) states No medications shall be transferred between containers. (see LIC 9102 Advisory Notes) Centrally Stored Medication Record (CSMR) of 2 out of 2 residents were found to be complete and accurate.

LPA reviewed Licensing Information System (LIS) Licensee/Administrator Doug Cattich who stated that is corrected and updated at this time; no need to change any of the information. In addition. Disaster Drills have been conducted quarterly with the last one being conducted on 4/4/2023.

There were no deficiencies cited at this time.

LPA Hansen is requesting Licensee to update and submit the following documents by 7/31/2023 to SRRO:

LIC 308 Designation of Facility Responsibility

LIC 610 Emergency Disaster Plan (if changes)