Facility Evaluation Report

Licensing Program Analyst (LPA), Carmen Lopez, conducted an unannounced case management visit for the health and safety of clients. LPA Lopez identified herself and was granted entry by caregiver Samantha Arevalo. LPA Lopez stated the purpose of the visit and reviewed the basic elements of the visit with caregiver Arevalo. Administrator Eliza Pangan arrived during the visit and briefly spoke with LPA as they were on their way to an appointment for another client.

This visit was in response to an Unusual Incident/Injury Report (IR) that was received at the San Diego Regional Office on Friday, November 15, 2024. The IR stated that client had awoken with a swollen left cheek. Staff notified the Administrator who informed SDRC and contacted the clients Dentist and was able to obtain an emergency appointment. According to the results, client had 2 fractured teeth and a broken infected molar. Client does have an upcoming dental appointment.

During today's visit LPA Lopez spoke with staff and requested and obtained relevant documents pertinent to this incident. LPA Lopez observed that clients were being picked-up for program. During this time client #1 (C1) had already left to program. There were three clients during the time of the visit who were also picked-up by their respective day programs during the visit. According to the Administrator, C1 was asked if they had any issues with their teeth and they denied any pain or issues. Administrator said that the C1 only felt pain that morning when they awoke with the swelling. They were unaware how the C1 obtained the fractures as they are pretty calm at home and at their respective program.

No deficiencies were cited during today’s visit.

An exit interview was conducted with caregiver Samantha Arevalo, and a copy of this report, LIC811 and Licensee Appeal Rights (LIC9058) were provided at the conclusion of the visit. The signature below confirms that the documents were received.