Follow-up on corrections·July 11, 2024

At approximately 2:15PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Case Management - Deficiencies visit, and met with Licensee/Administrator, Pilar de Olave. During the course of the Complaint Investigation dated for July 11, 2024, the Department learned that the Facility did not submit written reports to Community Care Licensing (CCL) per regulation. The Department received information that Resident 1 (R1) passed away on 07/03/2024. Licensee confirmed that they did not submit a Death Report or Special Incident Form (LIC624) to CCL timely ( deficiency cited, see LIC809D, regulation 87211(a)(1)(D)). LPA and Licensee discussed the importance of reporting incidents in a timely manner. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809D, Plan of Corrections, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.