Facility Evaluation Report

While at the facility conducting investigation of a complaint (Control # 15-AS-20260728172630) and upon review of Resident R1's record and the Department's efax folder and facility's efax folder for incident reports, LPA observed the facility did not submit nor the Department received an Unusual Incident Report for R1 for the fall incident that happened on 7/02/26.

The above were discussed with Campus Director (CD) Isabel Poderoso and over the phone with Administrator Janice Gombio.

Deficiency is cited from Title 22 California Code of Regulation 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 the Campus Director.

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