Facility Evaluation Report
On 10/07/2025 at 9:05 AM, Licensing Program Analysts (LPAs) P.Manalo and K.Nguyen arrived unannounced to conduct a Case Management visit to follow up on the admission of Resident 1 (R1). Direct Care Staff, Emma Ang, contacted Teresita Collong and explained the purpose of the visit. Administrator was unavailable to come to today's visit and gave authorization for Teresita to sign the report.
During the visit, LPAs reviewed R1's physician report, appraisal needs and services plan, and hospice binder. Record review showed that R1 was admitted to hospice on 09/24/2025. Physician report showed that R1 is non-ambulatory and has a contracture.
LPAs observed the following deficiencies during the visit:
Record review showed that R1 is on hospice and the facility did not send hospice notification to licensing.
Physician report dated 09/22/2025 showed that R1 is diagnosed with contracture without prior exception approval from the department.
Record review showed that R1's hospice binder is incomplete and not available for review during the visit.
The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties.
Exit interview conducted with staff. Appeal Rights and a copy of this report provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction