Facility Evaluation Report
On 10/26/2023, Licensing Program Analyst (LPA) K.Kaur arrived unannounced to conduct a case management inspection regarding incident report that was received in the CCL office. Incident Report occurred on 7/30/2023 regarding medication errors. LPA explained the reason for inspection and met with Executive Director/ Administrator, Amanda Kelsey
LPA conducted a medication audit and reviewed R1’s records and observed residents PRN medication was not documented when given.
Deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22,
An exit interview was conducted with the Administrator. Report signed on-site and printed copy provided with
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction