Facility Evaluation Report

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced case management visit to follow-up on multiple incidents reported to Community Care Licensing. LPA introduced herself and discussed the purpose of the visit with Executive Director Kimberly Garcia.

On August 6, 2025, Community Care Licensing received a self reported SOC341-Report of Suspected Dependent Adult/Elder Abuse forms in regards to an incidents involving Staff 1 (S1), and Resident 1 (R1). [LIC811 Confidential Names list to identify individuals]. According to the report, on an unreported date, R1 was having an aggressive episode and began to hit another unnamed resident. The report states it is alleged that S1 proceeded to forcefully control R1. Based on interview with Executive Director, there was not any additional information to prove S1 violated R1's personal rights.

Between July 7, 2025 and August 7, 2025, the Department received twenty-five incident reports that were outside out the allotted time frame for reporting requirements.

On August 6, 2025, the Department received an incident report from July 23, 2025, stating that R3 was not issued prescribed medication for 5 days after returning from the hospital. According to records, medication was prescribed July 19, 2025 and was initiated the night of July 23, 2025.

On today's date, two deficiencies were issued. An exit interview was conducted with Executive Director Kimberly Garcia to whom a copy of this report, LIC809-D and Licensee Appeal Rights (LIC 9058) were provided to.