Follow-up on corrections·August 17, 2023

Licensing Program Analyst (LPA) Kimberly Ramirez conducted a Case Management Visit-Deficiencies on 8/17/23 at 9 am, stemming from subsequent complaint investigation on 8/17/23. LPA Ramirez conducted tour of facility and records review in relation to complaint investigation. Deficiencies are being cited as a direct result of facility tour and observations made. Case Management-Deficiencies findings: · During medical record review of Resident #1 (R1) facility file, two (2) small insects that appeared to be “roaches” were observed crawling in between documents in R1’s file. Annual inspection conducted on 10/03/22, by LPA Long, resulted in deficiencies being cited. Facility was cited for violation of CCR- Maintenance and Operation 87303(a) “The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.” Plan of Correction (POC) indicated “Licensee shall obtain pest control services and provide proof to the department by POC due date of 10/17/22.” The facility submitted proof to clear POC on 10/16/22. Facility has failed maintain professional pest control services since 10/22. This is evidence by roaches still being observed in facility files and the facility’s failure to provide LPA Ramirez proof of continued professional pest control services at the facility. LPA Ramirez is issuing Civil Penalty Assessment for Repeat Violations in the amount of $250 for repeat violation within a 12 month period. Thereafter, a civil penalty of $100 a day will be assessed until the violation is corrected. Exit interview conducted with Administrator Samantha Alex. Deficiency and civil penalty were cited. A copy of this report and 809-D, LIC 421FC and appeals rights were provided.