Facility Evaluation Report
On 10/08/2025 at 1:05 PM Licensing Program Analyst (LPA) P.Manalo conducted an unannounced Case Management visit regarding a self-reported incident. Executive Director self-reported the incident on 10/03/2025. LPA met with Health Services Director, Gigi Tamayo, and Director of Operations, Angel Lee, and explained the purpose of the visit. The Executive Director was not available during today's visit.
On 10/04/2025, LPA received an incident report that Resident 1 (R1) was sent to the hospital for a worsening pressure injury on 10/03/2025 and is currently admitted to a skilled nursing facility.
During the visit, LPA reviewed and obtained the following documents such as R1's Physician Report dated 10/15/2024, Resident Appraisal, Care Plan dated 08/12/2025, facility's progress notes, and Physician Fax Report.
LPA will be requesting for R1's full medical record to be sent to CCLD.
Exit interview was conducted with Tamoyo and Lee and a copy of this report was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction