Follow-up on corrections·September 23, 2025

At 12:25 PM, Licensing Program Analyst (LPA) Huma Rahimi conducted unannounced visit to this facility in conjunction with a complaint control #31-AS-20250915193556. LPA met with Staff #2 (S2) Karyna Deputativa who granted access to facility. The Administrator was contacted and the Administrator arrived shortly after. LPA explained the reason for the visit. During the initial complaint visit that was conducted on 09/22/2025, LPA was informed that Resident #1 (R1) was hospitalized on 09/10/2025 due to dizziness, not taking insulin for three (3) days associated with sweating, and polydipsia. 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. LPA 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: 09/10/2025 (one incident) Continue on LIC 809C During the course of the complaint investigation LPA's review of R1's physician's report revealed that R1 cannot manage their own medications and injections. R1 diagnoses requires injections (insulin) to manage his/her diabetes. According to the Administrator and staff #1 (S1) interviewed, injections were given to R1 by S1 who is not an appropriate skilled professional. Additionally, LPA was informed that R1 is not receiving any HomeHealth nor hospice services. 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.