Facility Evaluation Report

At 7:30am on 03/13/2026, Licensing Program Analyst (LPA) Jeffries arrived unannounced to the facility to address an incident report that was submitted 03/09/2026 for a client black eye that was discovered on 03/07/2026. LPA was accompanied by Tri Counties Regional Center (TCRC) Quality Assurance, Adela Cortinas (QA). On 03/09/2026, LPA Jeffries contacted Administrator by phone requesting additional information to the incidents timeline for clarification. At the time of the visit LPA had not received additional information to the incident. At this visit on 03/13/2026, QA and LPA conducted interviews of Clients 1 (C1) and C2, as well as facility Administrator. Interview with C1, C1 stated that, black eye was a result of an accidental fall in C1's bedroom, and no other person was involved. C1 stated that they feel safe and taken care of in this facility. Additionally, C1 physically demonstrated to QA the physical event that cause the black eye (falling out of bed). Interview with C2, C2 stated that they feel very safe in the facility. Interview with Administrator, stated that the cause of the black eye was still uncertain, however the Administrator stated that she saw C1 at 5:45pm on 03/07/2026 with no black eye. Administrator stated that she noticed the black eye at approximately 6:00pm (15 minutes later). Based on interviews, observations, and admissions, this incident was the result of an accidental fall. QA and LPA discussed report writing with Administrator.

Eixt interview, report read, and report provided.