Facility Evaluation Report
On 04/16/2025 at 3:00 PM Licensing Program Analysts (LPAs) P.Manalo and K. Nguyen conducted an unannounced Case Management visit regarding a self-reported incident. Administrator reported the incident on 04/06/2025. LPAs met with Administrator, Amelia Alfonso, and explained the purpose of the visit.
LPA P.Manalo received a self-reported incident report from facility that indicated that the Client 1 (C1) had unexplained and unwitnessed fall. The incident report indicated that the client sustained a fracture.
LPAs conducted interviews during the visit, and discovered that C1 sustained two different fractures in the last 6 months.
LPAs are requesting for the facility to send the following documents such as PRN Medication Record, December On-Going Progress Notes, April On-Going Progress Notes, 2024 Physician's Report, and Change of Condition Report by 04/18/2025.
No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction