1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 | Licensing Program Analyst(s) Mary Flores and Luis Mora conducted a plan of correction visit at the facility for deficiencies cited on case management visit on 5/26/21. LPA(s) met with Jiezl Mate - Caregiver and explained the reason for the visit.
During the visit on 5/26/21 the following Type A deficiencies were cited under Title 22 Division 6 Chapter 8:
87200(a)(2) Fire Clearance
87303(e)(2) Maintenance and Operation
87465(e) Incidental Medical and Dental Care
87465 (h)(2) Incidental Medical and Dental Care
During today's visit the following was observed regarding the above deficiencies:
87200(a)(2) Fire Clearance - Licensee provided original LIC 200 during this visit. Deficiency cleared.
87303(e)(2) Maintenance and Operation - Water temperature was tested in Bathroom #1 and measured 118.5 degrees F. Deficiency cleared.
87465(e) Incidental Medical and Dental Care - LPA(s) observed medication cabinets and no PRN medication was observed without labels. Deficiency cleared.
87465 (h)(2) Incidental Medical and Dental Care - LPA(s) observed medication cabinet was locked. However, when LPA(s) inquired about a medication, caregiver stated to keep medication on resident #1's bedside to be able to provided to resident and observed caregiver grabbed medication from screening table next to R1. Regulation 87465 states that all medication must be kept lock at all times. Deficiency not clear. Therefore, an immediate civil penalties will be assess at this time in the LIC421FC for the period of 5/27/21 to 6/7/21 for the amount of $1200.
Exit interview was conducted with Jiezl Mate - Caregiver and a copy of the report, and LIC 421FC was provided. |