Facility Evaluation Report

Licensing Program Analysts (LPAs) Tricia Danielson Kathleen Banrasavong arrived unannounced to the facility to conduct a case management visit to address a deficiency observed during the investigation of complaint control number 18-AS-20230502105304.

During review of facility records on 5/10/2023, it was discovered that Resident #1 (R1) has a sole primary diagnosis of paranoid schizophrenia. R1's ongoing behavior is not compatible with the other residents of the facility and has upset the resident group in it's entirety. On 4/28/2023, R1 unjustifiably physically assaulted Resident #2 (R2), who is bedridden and non-verbal, with a hairbrush.

Therefore, based on LPA's observations, the following deficiencies were cited per Title 22, Division 6 of the California Code of Regulations. See LIC 809D. An exit interview was conducted and a copy of this report was provided along with LIC811- Confidential Names list and Appeal Rights.