Facility Evaluation Report

Licensing Program Analyst (LPA), Armando Perez conducted a case management visit to the facility for the purpose of issuing deficiencies related to complaint investigation 18-AS-20251030144849. LPA Perez met with Caregiver Carl Denney, and explained the purpose of the visit and assisted LPA.

During the investigation, information obtained revealed that Resident 1 (R1) had a hospital visit for a UTI on 10/19/25, experienced a fall on 10/25/25, and had a second hospital visit on 10/26/25 due to pain concerns.

LPA conducted a review of Special Incident Reports submitted by facility staff and did not find any documentation referencing incidents listed above. Interview with Administrator, Danny Barrett, ack nowledged the incidents with R1 occurred and could not provide Special Incident Reports submitted to Community Care Licensing Division upon request. As a result, a deficiency is being cited per Title 22 Division 6 of the California Code of Regulations.

An exit interview was conducted and a copy of this report, 809-D and Appeal Rights was discussed with and provided to facility representative.