Facility Evaluation Report

SLB Incorporated-old Valley, Moreno Valley09/07/2022Licence 336402597

Capacity6
Census6
Date signed04/26/2023 03:45:04 PM
The inspector’s account

Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced visit to follow up on information previously reported to the Department regarding an incident between Client 1 (C1) and Staff 1 (S1). LPA explained the purpose of the visit with Ms. David, and Administrator Jamielah Fortajada arrived shortly after LPA arrived. LPA had previously conducted a facility visit on 7/20/2022 in which LPA interviewed 6 residents, and 5 staff members regarding the incident.

The facility reported that the incident took place on an undetermined previous date. Reasoning given was that C1 was not complaining of pain or voicing the incident. The incident was not witnessed by anyone other than Staff 1 (S1). S1's last date worked was 7/10/22 before not showing for their shift on 7/14/22. The incident came to light on 7/13/22 when CEO Mr. Michael Hall noticed C1 not "himself". When Mr. Hall questioned C1 about it, C1 explained the situation involving S1 slapping C1 while in the restroom. As a precaution, Hall directed their staff to take C1 to Urgent Care to be examined.

During LPA's interview with C1, C1 reported that S1 had "hit" him, and immediately after, "fell out of his chair." During the interview of S1, S1 stated that S1 was having a "bad day" and that they weren't necessarily in the mood to handle R1 that day. Instead, S1 let their emotions get the best of them, and had engaged physically with C1. S1 had admitted to Mr. Hall that the incident was physical between S1 and C1 in which Mr. Hall later terminated S1 on 7/14/22, as a result of the situation.

This is an amended version of the report dated September 7, 2022.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction