Facility Evaluation Report
Licensing Program Analyst(LPA) Contreras arrived unannounced to conduct a case management visit. LPA was greeted by care coordinator Josephine Garcia. The purpose of the visit was to gather documents regarding an incident report submitted on 7/21/2025 and a death report submitted on 7/24/2025.
On 7/21/2025 CCL received IR regarding resident (R1) having a fall in the shower and hit their head on shower floor. Med tech called 911 and EMT's evaluated resident, however resident refused to be taken to ER for further evaluation. LPA asked care coordinator for refusal letter and discussed reporting and documentation requirements regarding resident refusals. Care coordinator provided LPA with resident incident report done by EMT/Firefighters stating resident refusal.
On 7/24/2025 CCL received death certificate regarding resident (R1) DOD on 7/22/2025. LPA requested death certificate as resident was not on hospice. Care coordinator provided LPA with death certificate.
No deficiencies cited during today's inspection.
Exit interview conducted with Administrator and a copy of this report was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction