Follow-up on corrections·October 5, 2023

Licensing Program Analyst (LPA) Javina George made an unannounced case management deficiencies visit as LPA was delivering findings for complaint control # 18-AS-20230803125541 and observed the following deficiencies. The facility admitted (accepted responsibility) for Resident #1 (R1) on or around August 3, 2023. Per interviews with Administrator Jamie Teng, there is a contract or agreement with a local skilled nursing facility (SNF) to discharge residents from the SNF to the facility. Due to this contract or agreement, the facility is accepting residents without properly screening them, as well as not completing the evaluation of suitability for admission. The evaluation consist of: (1) Conduct an interview with the applicant and his responsible person. (2) Perform a pre-admission appraisal. (3) Obtain and evaluate a recent medical assessment). Per an interview with Administrator Jamie, the LIC 602 (Physician's report) was requested but was never sent over. As a result of the facility not properly screening new residents. R1 was admitted to the facility and began exhibiting erratic behaviors by trying to hurt thyself. As a result the facility had to contact 9-11 to assist, and have R1 removed without returning to the facility. Further interviews conducted with R1's responsible party who deemed the facility was not suitable for R1 and they should have not been sent there due to their current mental state that R1 had been exhibiting for the past a couple of months. Additionally, LPA observed that when LPA requested the staff files for review from the Administrator Jamie Teng. Jamie stated that the facility was in the process of converting to electronic files. Jamie verbally provided Staff #1 (S1) and Staff #2 (S2) hire dates. In addition to Administrator Jamie provided a copy of the staff training checklist that was the exact same, however S2’s name is written over S1’s name that had been covered with white out. The hours are off center and the exact same hand writing. Interviews with S1 and S2 stated that they both received training prior to working at the facility. Not only did the Administrator make false claims but provided false training documents and is being cited in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8) on the attached 809D. An exit interview was conducted and a copy of this report, and appeal rights were reviewed and provided to Administrator Jamie Teng.