Facility Evaluation Report

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a case management visit. LPA Moleski met with Angelita Dayoan and explained the purpose of the visit.

LPA Moleski observed a large, purple bruise on a resident's (R1) cheek and around the eye. LPA Moleski interviewed two staff members (S1-S2), who said the resident fell on Monday, August 28, 2023. S1 said R1's family members were notified of the fall. S1 said R1's medications were recently changed, and she has been dizzy as a result. S1 said R1 was not taken to a hospital afterward. S1 was present during the fall, according to S1. LPA Moleski interviewed R1 and asked what happened to her face. R1 said she didn't know.

LPA Moleski reviewed a handwritten narrative written by S1. The narrative described R1 bumping her forehead. According to the narrative, R1's family and Dayoan were notified. LPA Moleski did not receive this handwritten narrative or any other incident report within seven days.

This facility is being cited per 22 CCR Section 87211(a)(1)(D). A civil penalty is being assessed due to repeat violations. An exit interview was held with Dayoan. Appeal rights and a copy of this report were left with Dayoan.