Facility Evaluation Report
Capacity6
Census6
Date signed09/08/2022 03:43:47 PM
At 3:00 p.m. on 09/08/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced case management visit. LPA met with Administrator and disclosed the reason for the visit. An Incident Report was submitted regarding Resident #1 (R1) who was admitted to the hospital after their catheter came off and urine bag was filled with blood.
LPA conducted an interview the with Administrator at 3:10 p.m. and conducted a record review at 3:20 p.m.
No immediate health and safety concerns were observed. No deficiencies cited.
Exit interview conducted. Copy of report issued.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction