Facility Evaluation Report

Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced Case Management Incident inspection at the facility today. The LPA met with Administrator Joeyvic Alvarado and explained the reason for the inspection.

On 03/21/2025, Community Care Licensing (CCL) received two (2) Unusual Incident/Injury Report (LIC 624) and two Self-Reports of Suspected Dependant Adult/Elder Abuse (SOC341) pertaining to Resident #1 (R1), Resident #2 (R2), Staff #1 (S1) and Staff #2 (S2). The first Incident report and SOC341 reported that on 03/20/2025, R1 was sitting on their chair by the window with their table in front of them, on their table there was a tray with their dog's food in a bowl with paw prints and R1's food in a container from the communities kitchen. S1 and S2 were with R1. R1 pointed at their dog's bowl and told S1 to warm up their food. R1 has poor vision. S1 warmed up the dog bowl, meanwhile S2 turned around as they did not want to see R1 eat the dog food and S1 gave it to the resident. R1 spat out the food and said "this is nasty, it's my dog's food." S1 took the food away and warmed up the correct food and gave it to the resident. S2 reported the incident to management. The second incident report stated that 03/20/24, S2 observed S1 be rough with R2 as S1 was assisting R2 in moving their legs to bed. It was further reported that the Administrator spoke with R2, who denied any staff had been rough with them.

On 03/21/25, LPA Cortez spoke with the Administrator on the phone. The Administrator stated that S1 was suspended, S2 will receive training on intervention, incidents were reported to ombudsman, resident, residents family, residents physician and Licensing. All the appropriate actions were taken.

Report will continue on LIC809-C, 2nd page.