Facility Evaluation Report
Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced Case Management – Incident visit for the purpose of investigating self-reported incident report. Upon arrival LPA and met with Administrator Connie Smiley and explained the reason for the visit.
On 05/18/2026, the Regional Office reviewed the following Self-reported incident reports:
On 05/12/2026, at approx 5:00 a.m., caregiver conducted routine round checks and found Resident #1 (R1) on the floor in front of their closet. R1 was assessed, 911 was called, then Paramedics arrived and R1 was admitted into a local hospital. Paramedics tested blood sugar and it was observed to be at 375.
On 05/15/2026, the family / responsible party notified Administrator that R1 passed away while in the hospital. Hospital doctors informed the family / responsible party R1 had several brain bleeds. Administrator has not received the death certificate at this time.
At approx 09:30 a.m. LPA conducted physical plant, interviewed staff, and reviewed and obtained copies of pertinent documentation relevant to the investigation.
Based on interviews and records review no immediate or potential health and safety concerns were observed during the visit and no deficiencies cited at this time. LPA has determined should further investigation be warranted, LPA will return at a later date.
Exit interview conducted. A copy of the report was issued.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction