Facility Evaluation Report

On 6/8/26, Licensing Program Analyst (LPA) arrived unannounced to conduct a case management visit for an incident that occurred on 2/23/26 which was reported on a SOC 341 on 4/3/26. LPA was granted entry into the facility by caregiver (Staff), Roselyn Martinez who was informed of the purpose of the visit. Employees, Alexis Parker and Matthew Guitierrez, arrived soon after. At the time of the visit there were 1 (one) staff member and 4 (four) clients present in the facility. Staff provided LPA with a Staff Roster, Client Roster and Staff Schedule.

SOC 341 reported the following. S1 was transferring R1 from the Hoyer Lift to a wheelchair. The sling on the Hoyer Lift was not adjusted properly and R1 slipped out. R1 hit his buttocks on the footrest of the Hoyer Lift and sustained a slight bruise and scratch. R1 was not seriously injured and did not require hospitalization. SIR was not completed in a timely manner.

During the visit, LPA toured the facility with Staff. LPA conducted observations, conducted an interview and obtained pertinent documents. A health and safety check was conducted at the facility and of the residents. No immediate health and safety concerns were observed at this time.

LPA informed Staff that the incident requires further investigation. Additional visits and/or phone calls may be necessary.

An exit interview was conducted with the Caregiver, Roselyn Martinez, and a copy of this report was provided to the Caregiver, Roselyn Martinez to be given to Administrator, Stephanie Olivas.