Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Case Management Visit-Incident on 04/15/2025, due to Unusual Incident/Injury Report (LIC 624) received on 03/31/2025. LPA was greeted by Erika Montoya-Assistant Administrator and LPA explained the purpose of the visit.

According to Unusual Incident/Injury Report (LIC 624) received on 03/31/2025, residents#1 & 2 (R1 & R2) got into a physical altercation on 03/28/2025. R1 suffered visible facial injuries. 911 was called and officer Chang from Claremont PD arrived. No arrests were made. Claremont Police incident report# 2500678 was provided to facility staff for reference. R1 and R2 were sent to the hospital. R1 & R2 returned to the facility on 03/28/2025 with an order to follow up with PCP. Records reviewed revealed facility staff notified R1 and R2’s responsible party, and primary care physician (PCP) on 03/28/2025 about the incident. R1 & R2 were roommates prior to the incident. Upon arrival back to the facility, R2 was relocated to another room. There have been no further incidents between R1 & R2. LPA Ramirez requested and obtained copies of residents#1-2 (R1- R2): Physician’s Report (LIC 602A), Appraisal/Needs and Services Plan (LIC 625), and facility staff observation notes.

No deficiencies were cited during this visit. Exit interview was conducted. A copy of this report was provided via email.