Facility Evaluation Report

Licensing Program Analysts (LPAs) Martha Arroyo and Brian Balisi conducted a Case Management - Deficiencies visit in conjunction with complaint visit (Complaint Control # 29-AS-20250822191726). The purpose of the visit is to issue citations for deficiencies observed during the initial complaint investigation.

During the initial visit on 08/29/2025, it was disclosed that Resident #1 (R1) has a colostomy bag and was reportedly receiving services from a Home Health Agency. The LPA requested a copy of R1’s Home Health care plan; however, facility staff were unable to provide the document at that time. Staff stated they would contact the Home Health Agency to obtain the care plan and forward it to the LPA. As of today's date, the care plan has not been received.

During today’s visit, staff interviews revealed that R1 is not receiving Home Health services for ostomy care. Staff reported that an individual not affiliated with a Home Health Agency is currently providing the care. The LPAs were unable to verify whether the individual providing ostomy care is a qualified or licensed skilled professional.

The following deficiencies were cited from the California Code of Regulations, Title 22 and California Health & Safety Code. (See LIC 809-D). The Administrator was informed that failure to correct deficiencies may result in future civil penalties.

Exit interview conducted, appeal rights discussed, and a copy of report provided.