Facility Evaluation Report

LPA conducted a case management visit and met with Administrator Narciso Bernardo. During the course of investigation of complaint#15-AS-20240308105135, LPA reviewed records and interviewed staff 1 (S1).

Based on C1’s Physician’s Report, C1 needs assistance for all personal needs. Based on interview conducted with S1, S1 states C1 is able to brush own teeth and does not need supervision.

C1 was reported to have had two wiggly teeth (one of which C1 pulled out), inflamed gum and teeth that appear to be decaying. On 3/8/2024, C1 showed LPA one wiggly tooth. LPA observed at least two teeth that appeared black in color. C1’s last visit with the dentist was in October 2022.

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

Exit interview was conducted and Appeal Rights was provided.