Facility Evaluation Report

While conducting an investigation of a complaint (Control # 15-AS-20221107163346), the Department learned that the facility did not do reappraisal and update Care Plan when R1's conditions changed. Medical records revealed R1 sustained fracture as a result of fall on October 10, 2022, and S1 stated R1's Care Plan was not updated.

Deficiency is cited from Title 22 California Code of Regulations and listed on 809D. Failure to submit proof of correction by plan of correction due date and any repeat violation within 12 month period may result in civil penalty.

Deficiency and plan and proof of correction were discussed with Rachell Paniagua.

Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.