Health check·October 30, 2024

Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose of conducting the health and safety case management visit to follow up on the death regarding Resident #1 (R1). LPA was greeted and granted entry after stating the purpose to Caregivers Javier Tamayo and Paloma Alonza. Administrator (Admin) Juan Reyes arrived shortly after. On October 29, 2024, the Department received the death report of R1. Administrator to forward a copy of the Coroner's Report and Death Certificate once obtained. LPA toured the facility with Administrator Juan Reyes. Facility was observed to be clean, sanitary, and in good repair. Facility maintains sufficient 2-day supply of perishable and a 7-day supply of non-perishable food. Toxins, medications, and sharps were secured and inaccessible to the residents. The certificate of liability insurance remains current. No health and safety violations were observed during the tour. LPA reviewed and took photographs of R1's pertinent documentation. Admin to forward copies of the following records to LPA via email by end of today's business day: Resident Roster, Death Report, Identification and Emergency Information, Physician's Report, Discharge Summary, Preplacement Appraisal Information, Assessment Form, Needs and Services Plan and Mortuary Information. Based on the review of the Guardian Employee Roster dated October 30, 2024, S1 and S2 were not associated to the facility at the time of inspection. Admin to submit a copy of S1's and S2's identification cards along with the completed Criminal Background Clearance Transfer Request Forms (LIC9182) by October 31, 2024. Based on today's visit, a deficiency is being cited, and an immediate civil penalty is being assessed. An exit interview was conducted with Administrator Juan Reyes, and a copy of this report including the LIC809-D, LIC421BG, LIC811s, and the appeal rights were provided at exit.