Routine inspection (multi-day)·January 29, 2025

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a continuation of the required annual visit at 10:50 A.M. LPA met with caregiver Calixto “Alex” Calixtro and discussed the reason for the visit. Licensee, Maricar Lee, was contacted via telephone. Licensee arrived at 11:15 A.M. Administrator, Michelle Parr, joined the visit shortly after. Entrance interview conducted. Physical plant tour was conducted during the Annual visit. Today, a brief tour was conducted. No health and safety concerns were identified during today's tour. Today, LPA will conduct a medication and files review; the following was observed: RECORD REVIEW: Between 11:20 A.M. and 1:30 P.M., staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. 6 (six) resident records reviewed were complete and contained all required documents. Six (6) staff files reviewed were complete and contained all required documents. MEDICATION REVIEW: Began at 1:45 P.M. Medications for six (6) residents were observed. All medications are centrally stored in a locked closet at the end of the hallway between room #1 and room #5. Prescribed medications including PRN were labeled, stored, and inaccessible to residents in care. LPA observed discrepancies on the Centrally Store Medication and Destruction Log for two (2) residents. Continued from LIC 809-C Continued from LIC 809 Additionally, during a medication audit, LPA observed that Resident #1 (R1) has a prescription for Tamoxifen 20MG tablet (90 qty) which was started on 01/05/2025. However, upon inspection of the pill bottle, LPA observed only 6 (six) pills remained. Licensee nor Administrator were able to provide an explanation for the missing medication. INTERVIEWS: During today's visit, LPA interviewed two (2) caregivers. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 809-D.) Administrator was informed that failure to correct the deficiencies may result in civil penalties. Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.