Facility Evaluation Report

On June 17, 2025, Licensing Program Analyst (LPA) Murial Han conducted a Case Management visit to follow up on an incident that was reported by the facility. LPA met with the administrator, Sally DeLa Cueva and explained the purpose of today's visit.

On March 3, 2025, the facility reported that while staff #1 (S1) was assisting resident #1 (R1) with a shower, S1 noticed a red mark on R1's left shoulder and was later found to have a Nondisplaced Distal Left Clavicle Fracture. The facility staff reported that there was no incidents, no falls and or accidents leading to the injury.

According to the Orthopedic Surgeon, it is likely the injury was sustained by a fall or walking into an object.

The Department has completed the investigation and no deficiency is being cited.

This report is reviewed and discussed with the administrator.