Incident investigation·October 29, 2025

On 10/29/2025 at 12:00 PM, Licensing Program Analyst (LPA) P.Manalo conducted an unannounced Case Management visit regarding a self-reported incident. The facility sent in an incident report on 10/27/2025 regarding R1's fracture. LPA met with Health Services Director, Gigi Tamayo, and Director of Operations, Angel Lee, and explained the purpose of the visit. The Executive Director was not available during today's visit. LPA P.Manalo received a self-reported incident report from facility that indicated Resident 1 (R1) had unwitnessed fall on 10/25/2025 and started experiencing pain on 10/26/2025. Responsible party brought R1 to the hospital and was treated with lower leg fracture on 10/27/2025. R1 returned to the facility day of with a leg brace. During the visit, LPA interviewed Health Services Director, Gigi Tamayo, and reviewed R1's Individualized Service Plan dated 10/27/2025 and 09/13/2025, Physician Report, and After Visit Summary. No deficiencies cited during visit. Exit interview was conducted with Tamayo and Lee and a copy of this report was provided.