Facility Evaluation Report

Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced case management visit. LPA met with the Administrator - William Coleman and Claudia Lujan - Director of Quality Assurance and disclosed the reason for the visit.

Facility has applied for a change of ownership application. The case management visit was conducted in conjunction with the pre-licensing visit today. Today’s case management visit was conducted for a welfare check for all clients. LPA observed sufficient food and water supplies in the facility. Two (02) out of four (04) clients were interviewed and observed to be in good health.

LPA interviewed staff and clients and toured the facility. LPA conducted a record review of all four (4) clients and three (3) staff records. LPA had received an initial and a follow up incident report regarding Client 1 (C1) who sustained bruises on the inside of the upper left arm on 05/10/2026. On 05/10/2026, C1 had ingested a plastic cheese wrapper and facility staff transported C1 to Providence St. Joseph Hospital-Burbank for evaluation. During the hospital visit, vital signs were taken. C1 forcefully had removed the blood pressure cuff from their arm, resulting in red marks and bruise. LPA reviewed the hospital report from 05/20/2026 regarding healing stages of bluish gray ecchymosis to the left upper extremity and noted that bruising appeared to be in healing stages. The physician’s recommendation at the time was to continue monitoring client. No medications were prescribed for the bruising at the hospital. LPA did not observe any bruising or marks on C1's arm today. During today's visit LPA asked C1 if they are in pain, who stated 'no'. Administrator stated client has tendencies of self abuse and anxiety, which may have caused C1 to get anxious in the hospital and to remove the blood pressure cuff forcefully.

At this time all clients and staff in the home are healthy and in good condition, and the facility itself remains safe and in good repair. No health or safety issues were observed during today's visit.

Exit interview conducted. Copy of report provided.