Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted a Case Management- Deficiencies visit due to record review findings while investigating complaint control #: 28-AS-20251024145312. The purpose of the visit was explained to Executive Director Kimberly Sanchez.

On 10/22/2025 at approximately 10 PM, Memory Care Unit resident (R1) had an unwitnessed falll and was found on the ground in their room. Staff called 911 emergency, notified physician, and family. As of today, an incident report has not been submitted to Community Care Licensing.

Per 87211(a)(1) Reporting Requirements. Each licensee shall furnish to the licensing agency such reports as the Departmen t may require, including, but not limited to, the following: A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.

Pursuant to Title 22 California Code of Regulations, a deficiency was cited.

Exit interview held with Kimberly Sanchez. A copy of the report and appeal rights were provided.