Facility Evaluation Report

Ont his day at around 3pm, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct a case management visit and met with Administrator Leea Burns. LPA explained to Burns the purpose of the visit. Nurse Manager Ashton Paul was also present at the facility during the visit.

Based on the incident report submitted to Community Care Licensing, Client 1 (C1) was in the backyard preparing for day program activities on 6/26/2023. As C1 was getting up, C1 lost balance and fell forward hitting front face on the pavement. Staff 1 (S1) observed blood coming from C1's nose. S1 called Nurse Manager and Lead Staff. C1 was transported to the hospital by staff.

A review of C1's discharge paper indicate " No maxillofacial fracture identified."

Deficiency is cited per Title 22 California Code of Regulations (refer to Lic 809D).

Exit interview with Administrator was conducted and Appeal Rights was provided.