Facility Evaluation Report
On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit in conjuction with complaint control number 22-AS-20250110122555.
During the visit, LPA Mendivil discussed reporting requirements as on the visit on 12/30/2024 LPA Mendivil observed Resident 1 (R1) on the floor of the living room. Administrator//Licensee Nargis Elahi stated she did not report the fall that occurred on 12/30/2024 because it did not result in injury of the resident.
LPA Mendivil reviewed reporting requirements with Administrator/Licensee Nargis.
LPA Mendivil requested document of LIC 602 Physician's Report for R1, Administrator/Licensee Nargis stated did not have a copy of LIC 602 at present time. LPA Mendivil reviewed resident records regulation with Administrator/Licensee.
Based on observations made during today's visit deficiencies are being cited. An exit interview was conducted and a copy of this report was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction