Facility Evaluation Report
On 11/21/2025 The Department conducted an unannounced visit to deliver findings for the alleged allegations for complaint Control Number 11-AS-20250909103914. LPA met with Joel Niblett (Administrator) as the purpose of the visit was explained.
On 10/17/2025 between the hours of 4:11pm - 4:20pm LPA conducted a records review and observed the following: the department did not receive a LIC 625: Serious/Unusual Incident Report in regard to Resident 13 (R13) shaking from fever and having chills.
The facility failed to report the incident as required to the department.
Deficiency cited under California Code of Regulation Title 22 Division 6 Chapter 8 are being cited on the attached LIC 809-D.
Exit interview conducted, appeal rights explained, and a copy of this report was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction