Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso arrived unannounced to conduct a Case Management - Incident inspection, on 7/28/26, and met with Administrator Tilly Molina Vazquez. Licensee/Administrator, RN, Mary Garcia arrived to meet with the LPA.

The purpose of this case management is to follow up on a SOC341 abuse report dated 5/12/26, and an incident report received on 5/13/26, regarding suspected theft of resident medication by a staff. Licensee had contacted licensing on 5/6/26 to report the incident, and stated they would follow with required document reports. Police were also contacted, including all required parties. All medications were observed to be locked up and inaccessible during the LPA's inspection.

The narcotic medication count of pain medication was documented at a total of 14 syringes when S3 came on shift, 5/5/26; The narcotic count of pain medication was counted at nine (9) pain medication syringes at the end of S3's shift, 5/6/26. This narcotic count recorded that five (5) pain medication syringes were missing, and no record of pain medication was provided to the resident (R1). No other staff was working the shift with S3 when the five (5) pain medication syringes went missing, on shift 11pm on 5/5/26 to 7am on 5/6/26. The staff, S3, was terminated due to the facility's investigation of the incident.

Licensee/Administrator Mary Garcia and Administrator Tilly Molina, will submit the requested documents as discussed during the inspection, regarding statements of all interviewed, including the declaration forms (LIC855), and termination document/information on former staff/S3. Please submit S3's training records as discussed, medication, caregiver, and any other training on record for the last year.

In review of the incident and SOC341, and information obtained, it is observed by the LPA that the facility addressed the incident appropriately. The Department will review information obtained to determine if further action is needed and/or any other information/documentation is needed.

No deficiencies cited during today's inspection. Exit interview was conducted with Administrators, Mary Garcia, and Tilly Molina Vazquez.