Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a Case Management Inspection and met with Rita Larson (Social Rehab Director).

During today's visit LPA is following up on an incident report received at CCL on 2/27/24 involving Client (C1). On 2/27/24 at around 9:00am staff (S1) noticed that C1 was given another client's medication cup (C2). Staff contacted immediately crisis stabilization unit for guidance. Staff notified facility Administrator and responsible parties. Per Rita, S1 was not paying attention and got confused due to having two clients with the same name. During today's visit, LPA observed that client's medications cups have their names on it and the cups are the same color. The facility terminated S1 immediately as of 2/27/24.

Also, LPA is addressing reporting requirements issue discovered during complaint investigation # 21-AS-20240201160245. LPA reviewed incident report logs for this facility, and it was determined that incident reports were not submitted to CCL. At the time of the investigation, the administrator could not provide proof that hospitalization of C3 was reported to CCL. LPA learned that the facility is going to submit a change in administrator. LPA is requesting documentation regarding a change of administrator to be submitted to CCL with the following:

Documentation Needed for Change of Administrator:

LIC 200 for change of administrator, LIC 501 Personnel Record, LIC 503 Health Screening Report - personnel, Copy of Administrator's certificate and Board Resolution stating who the Administrator is and that the board has approved of the individual.

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