Facility Evaluation Report

On 11/25/2025, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced case management - incident report visit. LPA met with the executive director Li Li and explained the purpose of today's visit.

On 11/20/2025 the Department received an incident report regarding R1 had a fall in their room in which they sustained a laceration on the left eye brow with the complaint of dizziness and pain. The resident was getting up to go and use the restroom without assistance from staff. This incident occurred on 11/18/2025 around 5pm. The resident was sent to the hospital where they received stitches to help heal the injury. The resident returned the next day on 11/19/2025 at approximately 1:40am. The resident did not suffer from any broken bones or other injuries besides the laceration. The resident's care plan and diagnosis is discussed with Li Li. The resident receives a high level of supervision regularly as part of the care plan, which includes assistance to the restroom due to their diagnosis and cognitive condition. Discharge instructions from the hospital was followed and no new conditions developed. Resident has not had any other falls since this incident. LPA discussed care plans and received a copy of the resident's care plan and physicians report.

Report is discussed and a copy is provided to the executive director.