Facility Evaluation Report
Capacity6
Census5
Date signed09/30/2024 01:27:19 PM
Licensing Program Analyst (LPA) M. Rankin conducted a Case Management - Deficiencies visit to deliver findings. LPA met with Jessica Rust Administrator and explained the reason for the visit.
During the Department’s investigation of complaint #29-AS-20240405155913, the following deficiency was observed:
On 03/29/2024, at approximately 1:30am, Resident #1 (R1) had an unwitnessed fall and sustained a fractured nose. Interviews and review of the Unusual Incident/Injury Report submitted by the facility revealed R1’s resident representative was notified of the incident by the hospital.
Citation issued, exit interview, appeal rights given.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction