Incident investigation·August 22, 2022

Licensing Program Analyst (LPA) conducted a case management visit to the above facility. LPA was met by Paul Dizon, Administrator and the purpose of the visit was explained. Licensee Laura Martz, reported on 08/22/22, a car accident that affected the facility above. A car came driving down on Gracelake Ave coming down the hill and drove through major street Hawthorne blvd and a cult de sac and hit the facilities outside brick wall. Then car kept going and hit the side of the garage and still kept going and hit another brick potted bed flower which was in front of home. The fire department and building and safety came to access damage and Reg Tagged the facility. They are not allowed to enter or occupy the residence. There are 4 non-ambulatory residents in the facility. 3 male 1 female, 2 are on hospice and hospice is working on transferring services for them to new placement. Hospice is St. Arsenius. All 4 resident will be moved to Emerald Isle Assisted living 2 #198201753 which has a capacity of 6 and current census is 5. 2 of the resident families are helping the facility to move their resident. The other 2 residents are being moved by Hospice. An exit interview was conducted with Paul Dizon, Administrator and copy of report provided.