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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604062
Report Date: 07/03/2020
Date Signed: 04/20/2023 09:38:11 AM


Document Has Been Signed on 04/20/2023 09:38 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:ELMCROFT OF POINT LOMAFACILITY NUMBER:
374604062
ADMINISTRATOR:KAREN ROPERFACILITY TYPE:
740
ADDRESS:3423 CHANNEL WAYTELEPHONE:
(619) 224-7300
CITY:SAN DIEGOSTATE: CAZIP CODE:
92110
CAPACITY:60CENSUS: 45DATE:
07/03/2020
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Licensee RepresentativesTIME COMPLETED:
12:10 PM
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Regional Manager (RM) Icela Estrada and Licensing Program Manager (LPM) Denise Powell conducted an office meeting at the licensee's request to discuss recent issues of concern, including multiple medication errors and personal rights of residents. The meeting was conducted via teleconference with the following participants (Licensee Representatives): Shamin Wu, Sharon McGuire, Eric Stromsky, Eugenia Liu, Kimberly Severns-Jones and Counsel Joel Goodman. During the teleconference, licensee representatives shared information and described actions taken to address the areas of concern. The facility conducted audits of residents medication records and acknowledged they found numerous discrepancies in medication documentation, transcription and administration requirements. The facility also conducted an internal investigation which determined staff did not follow required policies and procedures, which resulted in these medication errors. The facility has initiated plans of corrective actions including staff training in a variety of topic areas, ongoing charting audits and increased external oversight of medication practices and records. Facility plans to review all incident reports on a weekly basis to ensure timely reporting.
SUPERVISOR'S NAME: Icela EstradaTELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: Denise PowellTELEPHONE: 619-301-9770
LICENSING EVALUATOR SIGNATURE:
DATE: 07/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/03/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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