Follow-up on corrections·January 26, 2023

Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced case management visit to cite a deficiency noted during the initial complaint investigation visit. LPA met with Licensee Diep Malmberg and we discussed purpose of the visit. The following deficiency was noted: admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident’s representative, if any, and the licensee or the licensee’s designated representative no later than seven days following admission. Records review revealed a facility effective date of July 5, 2022. On December 19, 2022 Licensee Diep Malmberg advised LPA Serrano that a new admission agreement had not been presented to the existing residents of the previous facility. Interview with licensee on January 19, 2023 revealed they have not sent out new admission agreements to the existing residents of the previous facility. Licensee explained that five residents are currently covid positive and they cannot send the new admission agreement out while the residents are sick. Per Title 22, Division 6, Chapter 8 of the California Code of Regulations, the following deficiency is cited and listed on LIC809-D. An exit interview was conducted with Diep Malmberg to whom a copy of this report and the Appeal Rights (LIC9058 3/22) were provided to licensee.