Follow-up on corrections·May 21, 2024

Licensing Program Analysts (LPAs) Angela Panushkina and Huma Rahimi conducted unannounced visit to this facility in conjunction with a complaint control #1-AS-20240520161421. LPA met with Staff #1 (S1) who granted access to facility. The Administrator was contacted and LPA was informed that she's out of town and cannot come to the facility. At 10:25am, the designee, Arman Petrosya, arrived and LPAs explained the reason for the visit. During the visit, LPAs was informed that R1 had a difficulty breathing on or before 05/02/2024. 9-1-1 was called and R1 was taken to the hospital. However, no incident report was submitted to the Community Care Licensing Department (CCLD) in a timely manner. LPA reviewed all incident reports on a system and did not observe an Incident Report regarding R1. In addition, the Administrator admitted that no incident was submitted to the Regional Office (RO). Based on Title 22 Regulation: a written Unusual Incident / Injury Report shall be submitted to CCLD within seven (7) days of occurrence. LPAs informed the Administrator that all staff members are mandated reporters and they are all responsible for reporting. LPA informed the Administrator to submit an incident report that occurred on or before : 05/02/24 (one incident) Moreover, LPAs were informed the S1 have been working at this facility for two (2) weeks. However, LPAs reviewed LIS and did not observe S1 being associated with the facility. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are cited and noted on LIC 809D. Exit interview conducted, appeal rights and copy of report signed and delivered.