Facility Evaluation Report

On 8/28/2025 at 11:30 am, Licensing Program Analyst (LPA) Y. Brown arrived unannounced to conduct a Case Management visit regarding an incident that was reported to CCLD on 7/15/2025 . LPA met with care staff Shella Onia and explained the purpose of the visit. Shella phoned Administrator (AD) Mariano Alatorre who arrived around 12:15 pm.

Incident report for R1 was sent on 7/10/2025. LPA interviewed staff, obtained and reviewed a copy of R1's physician's report, after-visit s ummary notes, and R1's current and updated Appraisal needs and services plan. S1 stated that on 7/2/2035, R1 complained of pain in their right leg at nighttime. S1 stated that they consulted with R1's responsible party and the responsible party advised the facility not to call 9-1-1 and the facility staff gave R1 Tylenol. S1 stated that R1 continued having pain in their left leg and on 7/3/2025 at around 11:34 AM, facility staff called Royal Ambulance for a non-emergency transport to the Hospital.

The facility did not immediately telephone 9-1-1 when R1 stated that they were experiencing pain.

Deficiency is cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted. A copy of the appeal rights and this report provided.