Incident investigation·August 28, 2024

At approximately 12:40PM, Licensing Program Analysts (LPAs) Loera and Felias arrived unannounced to conduct a Case Management - Incident Visit and met with Executive Director, Corrine Tanchoco, and Resident Services Director, Jocelyn Vahle. The purpose of the visit was to follow up on self-reported incidents that were submitted to Community Care Licensing (CCL). Incident Report 1: CCL received an incident report on 08/15/2024. Report stated that on 08/15/2024, facility staff observed Resident 1 (R1) on the ground. Facility notified emergency personnel who determined that R1 did not need to go to the hospital. Facility made all appropriate notifications per regulation. Per conversation with Executive Director, R1 was on a respite plan with facility for 30 days, and has since moved out of the community. Incident Report 2: CCL received an incident report on 08/15/2024. Report stated that on 08/15/2024, Resident 2 (R2) called emergency services to be evaluated. Facility staff notified R2's responsible party. R2 was admitted to the hospital for a urinary tract infection (UTI) and received antibiotics. Facility made all appropriate notifications per regulation. Per conversation with Resident Services Director, R2 has been observed to be at baseline. No Deficiencies Cited during visit. Exit interview conducted. Copy of report and LIC811 (Confidential Names) discussed and provided to Executive Director and Resident Services Director. Signature on form confirms receipt of documents.