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25 | This is a corrected version of previously dated report 7/23/2024. Verbiage was corrected to reflect the correct civil penalty dollar amounts.*
Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Plan of Correction (POC) visit to clear deficiencies issued on 7/19/2024 during required annual inspection. LPA Ramirez was greeted by Caregiver Veilma Malitado and explained the purpose of the visit.
The following deficiencies were observed and documented on 7/19/2024 and had a POC date of 7/22/2024:
1. Type A- 87202(a)(1)- FIRE CLEARANCE *immediate $500 civil penalty was assessed 7/19/2024.
2. Type A- 87555(b)(26)- GENERAL FOOD SERVICE REQUIREMENT * $250 for repeat violation in 12-month period was assessed on 7/19/2024.
3. Type A- 87465(h)(2)- INCIDENTAL MEDICAL AND DENTAL CARE SERVICES * $250 for repeat violation in 12-month period was assessed on 7/19/2024.
Licensee did not send POC for violation 87202(a)(1) by 7/22/2024. The licensee sent LPA a copy of a request to increase the number of non-ambulatory residents at the facility. The licensee did apply for this in August of 2023; however, the licensee was not approved by this licensing agency or fire department to operate beyond the facility approved fire clearance. Therefore, LPA Ramirez will issue daily civil penalties for failure to correct violation of 87202(a)(1) from 7/23/2024 through 7/23/2024, in the amount of $100. Although the licensee did purchase additional nonperishables for six (6) residents for a minimum of 1 week, the licensee did not clear POC by sending proof of retraining of staff on this regulation by POC due date of 7/22/2024.Therefore, LPA Ramirez will issue daily civil penalties for failure to correct violation of 87555(b)(26) from 7/23/2024 through 7/23/2024, in the amount of $100. Licensee did secure medication that must be refrigerated in lock box; however, licensee did not send proof that staff received retraining by 7/22/2024. Therefore, LPA Ramirez will issue daily civil penalties for failure to correct violation of 87465(h)(2) from 7/23/2024 through 7/23/2024, in the amount of $100.
Total amount of civil penalties issued today $300.
Exit interview conducted via telephone with Administrator Yenny Indrawati, A copy of this report, 809-D, LIC 421IM, LIC 421FC and appeals rights was provided.
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