Incident investigation·May 6, 2025

Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced case management visit at the facility. The Administrator sent an incident report to let CCLD know that they have a busted pipe in the facility. At the time, the pipes burst and affected one master bedroom. When the inspector came to the facility to inspect and fix the pipe, they noticed that the floors in another bedroom was absorbed by water, so they have to evacuate the entire home. Two clients were placed at the Loving Arms Residential Care for Seniors II that is located next door. The Administrator sent CCLD and incident report for the busted pipes, but we are asking for an updated incident report and updated/detailed evacuation plan that describes how they will distribute medication, their plan to take the first aid kit and manual, how they will feed the residents, the staff that will stay at the hotel with the residents, how they plan on transporting the residents, notifying the next of kin to explain to them what has taken place and their plan to keep the residents safe, something more detailed than what we previously received. CCLD is asking for an updated/detailed evacuation plan. The facility is licensed to serve age range 60 and over. There are currently two individuals on hospice and one individual on home health. The Administrator will notify Continued on LIC 809C. the agencies of their evacuation to the hotel. The hotel the residents will reside at from May 6-13th, 2025 is Days Inn 17510 Pioneer Blvd, Artesia, CA 90701., 562 924 6700. If there will be an extention after May 13th 2025, the Administrator is planning on renting an Air BNB. A copy of this reports was given to the Administrator Lourdes Bisnar during the Exit interviewed.