Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced Case Management visit in conjunction with Complaint # 29-AS-20260120130811. At 10:24 a.m., the LPA met with Interim Executive Director (ED) Stephani Smith and explained the reason for the visit. Entrance interview conducted.

Throughout the complaint investigation, the LPA conducted a record review of Resident #1 (R1’s) documents and noted that R1 had a fall on 01/08/2026. Per discharged paperwork, R1 had a fall on 01/08/2026 and was sent to the Emergency Room (ER). No fractures were noted, however, R1 discharge diagnosis was listed as sacral contusion and left hip pain. The Executive Director (ED) at the time, Ken Mahler did not send an incident report regarding R1’s fall.

Per the California Code of Regulations, Title 22, Division 6, Chapter 8, the following deficiency was observed and cited during the visit (See 9099-D).

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