Facility Evaluation Report

This is an amended report of a report originally signed on 10/04/2024.

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Case Management visit. The LPA introduced himself and disclosed the purpose of the visit to Licensee Rathi.

During today’s visit, the LPA assessed an immediate $500 civil penalty in an LIC 421IM form. This civil penalty was in response to a previously substantiated complaint allegation (Complaint # 08-AS-20190809110049).

On August 9 th , 2019, it was reported to the Department neglect resulted in a resident sustaining a stage 4 pressure injury. The Department investigated and substantiated the allegation on September 30 th , 2020. At this time, pursuant to Health and Safety Code Section 1569.49, a civil penalty assessment is under review by the Program Administrator of the Community Care Licensing Division.

An exit interview was conducted with Rathi, to whom a copy of this report, LIC 421IM form, and the Licensee Appeal Rights (LIC 9058), were provided.