Facility Evaluation Report

On 09/09/2024 at 12:00 PM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to deliver findings on the allegations above. The LPA informed Meina Wu of the reason for the visit.

During the investigation of complaint 15-AS-20230831144512 , it was discovered by the Department that neither t he administrator nor the staff had documented Resident R1’s fall in early February 2022. Additionally, neither administrator nor staff had submitted the required unusual incident report (LIC 624) to the Department concerning R1's fall when she sustained a new compression fracture of the T12 vertebrae.

2 Type-A deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 809-D.

Exit interview conducted and a copy of this report was provided.