Follow-up on corrections·January 23, 2026

Licensing Program Analyst (LPA) Manuel Monter arrived unannounced to deliver the results of a complaint investigation 26-AS-20250812163239 . During the complaint investigation, a case management deficiencies visit was conducted due to violations discovered during the investigation process. LPA met with Wellness Director (WD) Trisa Cysewski and explained the purpose of the visit. The Department reviewed R1’s July and August 2025 Medication Administration Record (MAR). Based on a review, the facility is recording R1’s blood glucose level twice daily. The MAR is also tracking the change in glucose monitoring sensor every 2 weeks. The Department reviewed R1’s Physician’s Order Report, dated December 13, 2025. Based on a review R1’s glucose monitoring is scheduled to be completed daily at 5:00am and 5:00pm. R1’s glucose sensor is changed every 2 weeks. On January 8, 2026, LPA Manuel Monter interviewed Administrator (ADM) April Princesa. ADM stated R1’s family member changes R1’s censors every 2 weeks. ADM stated the med tech will provide the new censor to R1’ son and will observe the changing of the censors and will mark it on the MAR. ADM stated Medtech’s check the blood sugar for R1 by using the glucose monitoring device and check the blood sugar, via the censor. Page 1 Out of 2. On January 23, 2026, LPA interviewed Wellness Dirctor (WD) Trisa Cysewski. WD stated the facility can conduct a training with her medtechs she would send documentation showing her medtechs have been trained regarding R1’s glucose monitoring devices such as but not limited to: function, how the glucose censor is supposed to be changed, and interventions when the reading is out of normal ranges. LPA advised WD the facility to update R1's service plan to address the care and supervision for his/her dialysis. WD stated she will request a detailed physician order with parameters for the glucose monitoring device, such as who would change the sensor, and interventions when the reading is out of normal ranges. The Department reviewed R1’s Individual Service Plan, dated November 1, 2025. The plan states under diabetes; R1 does not require blood glucose monitoring. Furthermore, the individual service plan does not state who would be changing R1’s glucose testing censor and evaluating the area for any adverse effects. Deficiencies are being cited per California Code of Regulations, Title 22. See LIC809-D. This report was reviewed with Wellness Dirctor (WD) Trisa Cysewski and a copy of the report and appeal rights were provided Page 2 Out of 2. END OF REPORT