Facility Evaluation Report

Licensing Program Analyst (LPA) Katie Brown conducted this Case Management in conjunction with a complaint investigation (Complaint Control Number 24-AS-20260721102800). LPA explained the reason for this visit with Administrator (AD) Kameron Green.

During this visit, LPA toured the facility and conducted resident file review. During the tour, LPA observed that Resident (R1's) hospital bed has full side rails attached. It was confirmed that R1 is not on Hospice at the time of today's visit. AD has agreed to provide R1's Physician's Report via email.

A deficiency is being cited in accordance with California Code of Regulations on the attached LIC 9099-D.

An exit interview was conducted and Plan of Correction was developed. A copy of this report and Appeal Rights were discussed and provided.