Routine inspection (multi-day)·June 19, 2023

Licensing Program Analyst (LPA) Angel Ascencio arrived at the facility unannounced to conduct a required Annual visit. The LPA met with Staff Ulka Sawghavi and explained the reason for the visit. This is an annual continuation that was first conducted on 05/16/2023. The LPA toured the physical plant areas inside and outside, with Staff Ulka Sanghavi to ensure there are no health and safety hazards. Staff Files: At 10:30 a.m., LPA Ascencio reviewed five (5) staff files. Staff files were observed to be complete with the necessary documents. Resident Files: At 11:20 a.m., LPA Ascencio reviewed five (5) resident files. At 11:22 a.m., Resident #1 (R1) and R2, review of file revealed a missing LIC 602, Physician's Report. R1 was missing their Tuberculosis results in their file. Medication Audit: During medication audit review at 1:45 p.m., R3 had an empty bottle of Folic Acid 1mg and an empty bottle of Docusate Sodium 100 mg. LPA observed a routine medication order for both Folic Acid 1mg and Docusate Sodium 100 mg. Medications was not at facility during audit. Folic Acid 1mg has not been given since 03/11/2023 and Docusate Sodium 100 mg has not been given since 05/25/2023. Additionally, R1 and R4 did not have multiple PRN medication on file, such as Lorazepam 0.5mg, Robafen 5-10-100, , Seroquel 25 mg, Senna 8.6 mg, Loperamide 2mg, Milk of Magnesia, Tylenol 325 mg. Due to the facility not having their “as needed” medication at the facility, if R1 and R4 requested additional PRN medication, the facility would not be able to assist R1 and R4. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties Exit interview conducted and a copy of the report and appeal rights were issued to staff Ulka Sawghavi.