Follow-up·June 23, 2022

Licensing Program Analyst (LPA) Walters arrived unannounced to follow up on a lack of communication from facility and to guide the facility on a possible eviction. LPA was greeted by staff, Administrator, Samual Padama arrived later. During file review LPA learned of three incidents that were not reported to licensing involving resident's R1, R2 and R3. LPA reviewed incident report logs that confirmed that facility has not reported incidents to CCL within regulations. LPA observed a single pill in a box, per staff S1 the pill belonged to R4, who refused to take their PM medication on 6/22/22. LPA checked R4 medication log (MAR), the MAR indicated that S1 gave R4 their medication when they did not. S1 stated that when R4 refuses medication at night, they wait until the morning after to give them their medication. Per Administrator and S1, it is common for R4 to refuse their medication. LPA discussed with Administrator and staff ways to respond when a resident refuses medication which may include: documenting, notifying responsible parties, physician, and licensing when a resident refuses. LPA also observed a rope tied around 1 of the 2 facility exits preventing anyone from exiting. The facility was previously cited on 8/11/22 for obstructing a facility EXIT. (pictures taken). Administrator immediately removed. An immediate civil penalty for $1000.00 was issued today for obstructing one facility EXIT. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and or Health and Safety Code. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. This report was read and discussed with Administrator, Samual Padama. Appeal rights were provided.