Facility Evaluation Report

Licensing Program Analysts Victoria Willis and Caitlynn Felias arrived unannounced to conduct a Case Management inspection and met with Program Director, Janeen Vierra Taylor.

Facility submitted an incident report for client, C1 for a medication error. According to interview, C1 was accidentally given medication at dinner instead of bedtime, as prescribed. Another dose of the medication was then given at bedtime resulting in C1 receiving two doses in error. Per interview, the second error occurred because of confusion during documentation of a medication change. C1 had no adverse affects due to to error. Additional staff training was conducted.

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.