Incident investigation·February 2, 2023

Licensing Program Analyst (LPA) Hansen conducted an unannounced case management and met with Terence Tumbale, Administrator. The purpose of this case management inspection is to follow up on 3 self reported SOC 341's submitted to Community Care Licensing (CCL). CCL received 3 self reported SOC 341 forms on 1/26/2023 reporting on 1/25/2023 and for the past two weeks S1 was reported by resident R1, R2, and R3, to have been verbally aggressive with residents. S1 has been suspended pending investigation. Submitted reports cross reported to Local Ombudsman, DOJ and responsible parties. LPA made copies of internal investigation notes, records, conducted interviews and made observations. Administrator agrees to inform LPA when internal investigation is complete and how facility is going to proceed regarding alleged abuse reported. During investigation LPA identified (S1) did not have criminal record clearance as required, to be working in a facility. Facility being cited under 87355(e)(1)(see LIC 809-D). ***An immediate civil penalty was assessed in the total amount of $500 The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided. Appeal of Rights Given ,