The licensee reported ongoing difficulty obtaining complete and timely medical and medication documentation from R1’s Power of Attorney 1 (POA1 ), including an updated Physician’s Report (LIC 602). The licensee reported that repeated requests for updated documentation had not been fulfilled, which impacted the facility’s ability to safely administer medications and meet the resident’s care needs.

LPM reiterated that medications must only be administered in accordance with written physician orders and that verbal direction from a POA is not sufficient authorization. The facility was advised not to administer medications without complete documentation and to ensure medication administration records, centrally stored logs are maintained and accurate, including appropriate measuring devices for liquid medications.

The licensee reported that two individuals are identified as holding Power of Attorney for the resident, POA 1 and POA 2 at 50% each. Licensing clarified that if both individuals have legal authority, the facility must include both in communications and may not exclude one at the direction of the other.

The licensee reported having previously issued a 30-day eviction notice and as of the date of this meeting, had still not received medical/medication documentation as requested.

Continued on 809-C

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

The licensee reported observing significant swelling and dark discoloration on the R1’s foot and had brought that to the attention of the POA 1 but had not received a response on how to seek treatment or care. LPM advised the facility to arrange for an immediate medical evaluation. The facility was advised that it remains responsible for ensuring timely medical care regardless of POA 1’s response.

The licensee also reported increased difficulty with safe transfers due to the R1’s limited mobility and resistance to care, which increases fall risk. LPM advised licensee to reassess R1 and maintain documentation of changes in condition.

Licensing reiterated resident rights regarding visitation and clarified that the facility may not enforce improper visitation restrictions imposed by a POA if they infringe on resident rights.

The licensee was advised to maintain written documentation for R1 of all care provided, refusals, and their communications with POA 1, and to send written summaries following discussions to ensure clarity and continuity.

CCLD will review submitted documentation and provide guidance as appropriate. The focus of Licensing involvement is on regulatory compliance and resident safety.

A copy of this report was emailed to Licensee/Administrator Lucia Boboc for their signature and returned to Community Care Licensing (CCLD) by emailing to LPM Richardson at stephen.richardson@dss.ca.gov by close of business 01/07/26.