Incident investigation·July 30, 2024

Licensing Program Analyst (LPA) Kimberly Ramirez conducted a Case Management Visit-Deficiencies on 07/30/2024. LPA Ramirez was greeted by Caregiver Marianaila Macalino and explained the purpose of the visit. Back up Administrator Rebecca Sinclair arrived shortly after. Case Management-Deficiencies findings: On 7/23/2024, LPA Vaid conducted a subsequent complaint investigation, and it was revealed to LPA Vaid that the facility was experiencing an active epidemic outbreak. Per Title 22 , Division 6, Chapter 8, Article 04, Operating Requirements, 87211(a)(1)(2) Reporting Requirements- (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility. (B) Any serious injury as determined by the attending physician and occurring while the resident is under facility supervision. (C) The use of an Automated External Defibrillator. (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. (2) Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. Per staff interviews, Resident#1 (R1) tested positive for a communicable disease on 7/22/24. On 7/23/24, (R2), (R3) and (R4) tested positive for a communicable disease. During records review, LPA Ramirez could not locate a report in R1, R2, R3 and R4’s file regarding an incident that threatens their health on 7/22/24 and 7/23/24. This licensing agency did not receive notification of a epidemic outbreak within 24 hours from 7/23/24. LPA Ramirez will issue a Type B deficiency based on records reviewed and interviews with staff. One (1) deficiency was cited during visit. A copy of this report and appeals rights was provided.