Facility Evaluation Report

On 9/18/2023, Licensing Program Analyst (LPA) K.Kaur arrived unannounced and conducted a case management – deficiencies visit in regards to a self-reported incident that occurred on 02/02/2023.

Based on incident report Resident (R1) observed an unattended knife left on the kitchen counter while staff were cooking and stabbed Resident (R2). LPA interviewed Administrator (AD) and reviewed Residents facility file and gathered copies of documents. The licensee shall employ staff as necessary to ensure provision of care and supervision to meet client needs.

Deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22,

An immediate Civil Penalty of $500 is issued. An exit interview was conducted with Administrator. Report signed on-site by Administrator and printed copy provided with appeal rights.