Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted a case management visit to issue a deficiency observed during a complaint investigation. LPA explained the purpose of this visit to LVN, Sabyne Francis.

Based on interviews conducted with Staff for complaint #28-AS-20220328110826, four (4) out of six (6) staff observed Client #1 with a bruise on the left leg towards the beginning of week 3/21/22 - 3/25/22. They stated it was reported, however, there was no documentation of the bruise on record. Client #1's large bruise was not reported until 3/25/22. Community Care Licensing received the Usual Incident Report for this incident, which only documented the bruise on 3/25/22 after the Administrator learned about it and the police were involved. There were no incident report submitted when staff first observed Client #1's bruise.

A deficiency is cited on the LIC809D in accordance to Title 22 regulations.

An exit interviewed was conducted and a copy of this report was provided.