Facility Evaluation Report

Licensing Program Analysts (LPAs), Mariana Agban and Angela Panushkina, conducted a CASE MANAGEMENT visit in conjunction with a complaint (#31-AS-20230615153708) and met with the Administrator. LPAs explained the reason for the visit.

LPAs were informed that on 11/04/22 R1 checked self into Skilled Nursing Facility (SNF) and the incident was not submitted to the Community Care Licensing Department (CCLD) in a timely manner. Based on Title 22 Regulation: a written Unusual Incident / Injury Report shall be submitted to CCLD within seven (7) days of occurrence. LPAs informed the Administrator that all staff members are mandated reporters and they are all responsible for reporting.

During today’s visit, the Administrator provided a copy of a written Incident Report.

Per the California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are cited and noted on LIC 809D.

Exit interview conducted, appeal rights and copy of report given emailed to the Executive Director.