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-20250408080938). The purpose of the visit is to issue a citation for deficiencies observed during the initial complaint investigation.

During the visit on April 14, 2025, the LPA observed deficiencies unrelated to the complaint allegations. During the plant tour, which began at 9:15 a.m., the LPA observed five (5) beds total in Bedroom #2. Resident #1 (R1) and Resident #2 (R2) currently share Bedroom #2; however, there were three (3) additional beds. Staff interviews revealed that the extra beds are being temporarily stored in the room and will be moved to storage shortly. Additionally, although the facility has a designated staff room on the premises, interviews indicated that a staff member occasionally sleeps in Bedroom #2 next to R2 due to R2’s tendency to wander at night and their increased risk of falling.

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