Follow-up on corrections·July 19, 2023

Licensing Program Analyst (LPA) Christine Dolores arrived to the facility unannounced and met with Administrator (ADM), Bhupinder Kaur. A case management – deficiencies visit was conducted based on violations that were observed during a complaint investigation. During the complaint investigation, LPA observed the facility does not maintain current records at the facility. LPA observed the resident’s physician’s report contained different facility addresses and the resident roster shows the incorrect facility name. On 07/19/23, ADM states she has a DBA of "Diya Senior Care Home" which is why she uses that name on the facility's records. LPA informed ADM that the facility records should be maintained and correct per the License of the facility. ADM stated understanding. During the complaint investigation, it was also found on 03/15/2020 a resident (R1) eloped from the facility. ADM filed a missing person report, called hospitals, and found R1 was at the Santa Clara Valley Medical Center. R1 returned to the facility on the same day. Based on record review, on 05/12/2020, a case management visit was conducted by LPA Joanne Roadilla in which the case management was pending due to additional reports. Based on the requested reports, R1 was diagnosed with a severe neurocognitive impairment and was unable to leave the facility unassisted. The review of records show, R1’s needs and services plan was not updated to reflect a plan to address R1’s behavior of elopement. A deficiency was cited per California Code of Regulations, Title 22. See LIC809-D. Advisory note provided. This report was reviewed with Administrator, Bhupinder Kaur and a copy of the report and appeal rights were provided.