Facility Evaluation Report

Licensing Program Analyst (LPA) Magda Malcore conducted a case management visit based on observations made during complaint investigation 56-AS-20250904132613. LPA met with Caregiver, Floredeliza Salvatierra and informed the purpose of the visit.

Today (9/10/25), LPA observed resident #1 (R1) with a forehead injury. R1 did not respond to LPA’s interview attempt due to their cognitive condition. Staff interviews reveal that, on 8/28/25, R1 sustained a forehead injury due to a fall. Staff called 911 and R1 were admitted to hospital. R1 was discharged the same day. Staff interviews reveal that a written incident report was not submitted to the Community Care Licensing Division (CCLD) regarding R1.

A deficiency is being cited in accordance with Title 22 of the California Code of Regulations. An exit interview was conducted where reports (LIC809 & LIC809-D) were discussed. Report copies were provided with appeal rights to Caregiver Salvatierra at the conclusion of visit.