Follow-up on corrections·January 29, 2025

Licensing Program Analysts (LPAs), Nadia Shahbazian and Angela Panushkina, conducted a CASE MANAGEMENT visit at this facility to issue deficiency in conjunction with complaint control no: 31-AS-20250122142449. LPAs met with the Administrator and explained the reason for the visit. LPA conducted a physical plant walk through, at approximately 10:15 AM, to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. At 10:20 AM, LPAs conducted an interview with the Administrator, two (2) staff members and five (5) residents. LPAs also requested and reviewed five (5) resident files. Upon review of documents LPA observed the following: Resident #2 (R2) is currently on hospice and R3 (non-hospice) had full bed rails. Review of records revealed that both residents had no Physician's order on file. R1 and R5 had half (½) bed rails. Review of R1's and R5's facility records revealed that no Physician's order was available. Moreover, LPAs observed five (5) out of five (5) residents facility files were incomplete, missing forms and and signatures. During the interview with S1 and S2, LPAs were informed that they stay at the facility at night and S1 is sleeping in a stow away bed and had his/her personal items in the room #1 Continue on LIC809-C In addition, during the interview with R2, LPAs were informed that S2 sleeps on the bed in room #3. Interview with S2 confirmed that during the night time, S2 is sleeping in R2's room. LPAs reviewed the facility license and observed that the facility is licensed for awake staff. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are cited and noted on LIC 809D. Exit interview conducted. Appeal rights explained. Copy of this report signed and delivered.