Senior Care Records.

Facility Evaluation Report

Fairfield, Union City08/10/2023Licence 019200254

Capacity4
Census4
Date signed08/10/2023 05:28:12 PM
The inspector’s account

On this day at around 3:30 pm, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct a case management - incident visit to follow up on Client 1 (C1). LPA was met by staff Omar Rivera. Lead staff Maria Teresa Bacaron arrived at a later time. Administrator arrived at around 4:30 pm.

On August 7, 2023, the Department received an incident report in regards to C1 falling in the bathroom on August 3, 2023. Facility reported that S3 notified Nurse Manage Ashton Paul prior to calling 911 despite seeing blood coming from C1's head. C1 was sent to the hospital. Discharge paper indicates C1 sustained laceration of scalp. Facility reported C1 sustained one stitch on the forehead.

At around 3:45 pm while at the facility, LPA observed C1's forehead and under right eye with bruises. LPA also observed a healing wound on C1's forehead. LPA interviewed Staff 1 (S1) and Staff 2 (S2) who both state that if a client falls, they call 911 immediately then notify Nurse Manager.

LPA obtained a copy of safety training that was conducted on 8/8/2023. However, facility does not have any safety training conducted prior to C1's fall on 8/3/2023.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction