Facility Evaluation Report
On August 22, 2024, Licensing Program Analyst (LPA) Murial Han conducted an unannounced Case Management- Health and Safety visit to follow up on an incident that was reported by the facility. LPA met with the administrator, Phil Surdel and explained the purpose of today's visit.
On August 19, 2024, facility submitted an incident report to CCL that on August 18, 2024, resident #1 (R1)'s responsible party reported to the facility that R1 sustained fracture ribs and on the report, it indicated that there was an incident that happened on August 15, 2024 between R1 and staff #1(S1) which may resulted R1's injury.
During today's visit, LPA met with R1 and requested documents to be submitted to CCL by 4:30pm today.
No deficiency is cited today. Incident requires further investigation.
This report is reviewed and discussed with the administrator
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction