Senior Care Records.

Facility Evaluation Report

Nelville Guest Home, Pasadena06/14/2022Licence 191222631

Capacity6
Census5
Date signed06/14/2022 12:29:36 PM
The inspector’s account

During the complaint investigation, Licensing Program Analysts (LPAs) Christine Wong and Benette Pena interviewed administrator and reported that they did not report the incident about client#1 hit client#2 to any responsible party on April, 2022. Administrator reported due to there's no medical attention needed and its not reportable. Therefore she did not file any incident report and assigned LPA got any incident report from administrator too.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA observed the following deficiency and issued a citation.

An exit interview was conducted and a copy of the report and Appeal Rights were provided to Administrator Hermania De La Cruz

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