Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced case management visit regarding an incident that was not reported to the Community Care Licensing Department in a timely manner. LPA met with Mona De La Rosa (Licensee) and explained the reason for the visit.

On 12/05/2019, C1 was taken to the hospital and was diagnosed with a fractured finger. The facility did not notify or submit an incident report to the Community Care Licensing (CCLD). On 04/01/2020, CCLD was made aware of this incident because a complaint was received.

The deficiency cited is documented on the LIC809D. Exit interview held and a copy of the report and appeal was provided.