Facility Evaluation Report

On 11/19/21 at 11:00am Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced Case Management Inspection to address additional concerns regarding an incident report received on 11/18/21 regrading R1 (see confidential name list, LIC 811 dated 11/19/21).

LPA met with Staff members S1 and S2 and conducted interviews with the two staff members. LPA also conducted a walk through of the facility and observed no bath mats or non-slip surfaces in the bathroom where R1 had fallen and received a laceration above his right eye which required medical attention and the laceration was glued closed by a medical professional.

Based on the interviews conducted, LPA's observations and documentation reviewed, the department has determined the facility did have a bath mat but was not being used at the time of the incident. Additionally, the department determined R1 should have been assessed by a medical professional as soon as it was determined R1 had obtained a head injury as a result of the fall to rule out any neurological injuries such as concussion.

The following deficiencies are cited per California Code of Regulations, TITLE 22.

Exit interview was conducted with the licensee. Appeal Rights were issued, and a copy of this report was left at the home.