Senior Care Records.

Facility Evaluation Report

Henrietta's Leven Oaks, Monrovia01/09/2024Licence 198603586

Capacity80
Census38
Date signed01/09/2024 03:42:43 PM
The inspector’s account

Licensing Program Analyst (LPA) Tena Herrera conducted a case management visit as a result of a deficiency observed during a complaint investigation, under complaint control # 28-AS-20240103165532 . LPA met with Administrator Claudia Sanchez.

During complaint investigation it was revealed that facility did not submit a special incident report on an incident that occurred on 1/2/24 to licensing. The incident was an altercation between R1 and R2 where R2 threw food and coffee on R1 and resulted in authorities being called and police report being taken (no injuries were reported).

Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiency observed during the visit are documented on 809D.

Exit interview held and a copy of the report along with appeal rights were provided to Administrator Claudia Sanchez.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction