Follow-up on corrections·June 1, 2022

On this day, 6/01/2022, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct a case management visit. LPA met with Executive Director (ED) Diane Pederson and informed the purpose of visit. During the course of investigation for complaint (#15-AS-20200710153037), the following deficiencies were observed: Facility staff did not update resident’s (R1) Appraisal/Needs and Services Plan after each change in condition/hospital visit. Executive Director (ED) stated that the facility updated R1’s care plan after R1’s first fall on 11/16/2019. Staff continued to use the same updated care plan moving forward, only adjusting the need for increased safety checks and providing constant reminders to R1 to utilize her pull cord. R1’s records revealed only two (2) Appraisal/Needs and Services Plan on file dated 9/23/2019 and 11/18/2019. It was also noted that during interview of R1’s family member (FM1) that R1 ran out of one of the medications. Facility’s records indicated they had contacted FM1 on December 2019 to pick up the medication from the pharmacy and that FM1 picked up the said medication and delivered to facility on 12/6/2019. However, when LPA requested for copies of LIC622 Centrally Stored Medication and Destruction Records on July 23, 2021 for further review, ED stated the facility no longer have the documents. On 2/07/2022, LPA verified and ED confirmed they no longer have the records. D eficiencies are cited from Title 22 California Code of Regulations on 809D. Failure to correct deficiencies and any repeat violations within 12 month period may result in civil penalties. Exit interview conducted. A copy of this report, Appeal Rights and LIC9098 Proof of Correction form provided.