Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Case Management - Incident visit to follow up on the visit conducted on 1/30/2025. LPA Rai met with Caregiver, Petronio (Ronnie) Libera. LPA Rai spoke with Administrator (ADM) Julius Javier over the phone and stated the purpose of the visit.

The purpose of the visit is to hand deliver an immediate exclusion letter for an individual (S1) who the Department determined engaged in conduct inimical as a staff in the facility. The letter was sealed and handed to the Caregiver, Petronio (Ronnie) Libera .

On 1/30/2025, the Department received an Incident Report stating on 1/29/2025 regarding alleged physical abuse by staff (S1) towards resident (R1). Staff (S2) observed the incident and stated S1 kicked R1 while R1 was crouching down on the floor in the room. S2 stepped in and stopped S1 from kicking R1 again.

Per Administrator (ADM) Julius Javier, S1 employment was terminated immediately after the incident occurred.

During today's visit, the Department issued deficiency under 80072(a)(3) Personal Rights due to S1's physical abuse towards R1. This is a serious matter and the Licensee is culpable of the actions of the employee at the facility.

Deficiencies were cited per California Code of Regulations, Title 22. See LIC 809-D.

Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Administrator (ADM) Julius Javier over the phone and a copy of the report was provided to Caregiver, Petronio (Ronnie) Libera. Appeal Rights were provided.