Facility Evaluation Report

Licensing Program Analysts (LPAs) Arielle Pascua and Christina Valerio arrived unannounced to this facility to conduct a case management visit. LPAs were greeted by staff member, Andrea Rush and explained the purpose of the visit. LPAs asked that SM Rush contact the Facility Designated Administrator (FDA) at this time to inform them that CCL was present. SM Rush was unable to contact FDA Julian Hawes via telephone. LPA proceeded the visit with SM Rush.

Current census was 4.There was one other staff member present, Alma Moyamoy.

A complaint was received by the department alleged that the facility did not administer medication as prescribed. It was learned through the investigation that during two separate outings the resident did not receive the correct amount of medication. On 10/22/2023, the resident went home for their first home visit and it was observed by family during medication administration that the medication provided to the resident was another resident's medication box. On 11/23/2023, the resident went home for a second visit and when night medications were provided it was observed that only one pill was available for a 3 night visit. The responsible party reached out to the facility and it was learned that the facility did not provide the resident with their refill. The responsible party was able to obtain extra medication for the remainder of the nights to ensure that the resident was given their medication on time.

Per California Code of Regulations, Title 22 Division 6, Chapter 8, deficiencies are being cited today in violation of California Code of Regulations.

An exit interview was conducted and a copy of this report was provided to the facility via email and an electronic email read receipt confirms receiving these documents.