Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit to conduct a Case Management (Deficincies) visit.. LPA Hurt met with Licensee Mathew Mazirek and explained the purpose of today's visit.

LPA Hurt reviewed Special Incident Report documenting at 4:30 a.m. on 01/03/2023 a facility caregiver heard Resident 1's bed alarm go off and upon checking on her found her on the floor near her bed and night stand. The care giver saw Resident 1 had hit her head. The facility staff called the ambulance and Resident 1 was transferred to Natividad Hospital.

This incident was not reported to Community Care Licensing.

The following Deficiencies are being cited Per Title 22 Regulations.

A copy of this report along with Appeals rights Provided.