Facility Evaluation Report

Licensing Program Analyst, Gina Saucedo arrived on 12/15/25 for an unannounced inspection to follow up on a substantiated allegation on a complaint investigation.

On April 22, 2022, the Department concluded a complaint investigation regarding the following allegation: Resident sustained pressure injuries while in care.

The allegation was substantiated, and the licensee was cited for violating California Code of Regulations (CCR) Title 22, Section 87615(a)(1), Prohibited Health Conditions.

The Department has concluded an analysis and has determined that a civil penalty is warranted for serious bodily injury. The Welfare and Institutions Code Section 15610.67 defines serious bodily injury as “an injury involving extreme physical pain, substantial risk of death, or protracted loss or impairment of a function of a bodily member, organ, or of mental faculty, or requiring medical intervention, including but not limited to hospitalization, surgery, or physical rehabilitation.” This is evidenced by the facility failing to provide care and supervision, necessary to meet R1’s health care needs, resulting in serious bodily injury- two stage 3 pressure ulcers (injuries/wounds) that required hospitalization, surgi cal intervention (incisional debridement) and transfer to a higher level of care.

Today, 12/15/25, the Department will be issuing a civil penalty per Health and Safety Code § 1569.49(f) for a violation that the Department constitutes as serious bodily injury in the amount of $10,000.

Exit interview conducted. A copy of the report issued. Appeal rights provided, David Aguiniga, Administrator and signature on this report acknowledges receipt of the appeal rights, found on page two of LIC 421D.