Facility Evaluation Report

Licensing Program Analyst (LPA) Martha Arroyo conducted a Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint Control # 29-AS-20250404131959). The purpose of the visit is to issue a citation for a deficiency observed during the initial complaint investigation.

During today’s visit, records reviewed and interviews conducted revealed that Client #1 (C1) has been experiencing recurring medical episodes, during which 911 has been called to assess and assist C1. A review of the facility’s records did not show or indicate that any of C1’s incidents were reported to Community Care Licensing (CCL). Staff stated that they were not aware of any incident reports for C1 being submitted to the department. Additionally, C1’s Needs & Service Plan needs to be updated to reflect C1’s current condition and outline how the facility staff plans to address C1’s needs, as staff indicated they are aware that C1 requires a higher level of care than the facility can provide.

The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. A copy of the report and appeal rights were provided.