Facility Evaluation Report

Licensing Program Analyst (LPA) Jey Cardenas conducted a case management - incident visit to check on the health and safety of clients in care on 09/08/2021 at approximately 12:12pm. LPA met with Administrator, Crystal Garcia, LPA conducted risk assessment, the facility is clear of Covid-19 infection. LPA informed Ms. Garcia that the purpose of today's visit was to follow-up on an Unusual Incident and Injury Report received by the Department relating to unexplained injuries on Client (C1).

During today's visit, LPA toured the facility with Miss Garcia. LPA observed the clients to identify any immediate health and safety threats. LPA attempted to interview C1, however LPA was unable to communicate with client due to client is non-verbal. C1 body check was conducted by Ms. Garcia and LPA observed bruising on C1s body. LPA reviewed C1's file and staff files.

-Staff statements related to the incident.

-C1's IPP/ Needs and services/ Appraisal/ Emergency sheet/ Physicians Report

No deficiencies were cited. Exit interview conducted and a copy of this report to be provided to Administrator, Crystal Garcia via email.