Follow-up on corrections·February 23, 2022

Licensing Program Analyst (LPA) Jennifer Semin conducted an unannounced visit to the facility for a case management visit in conjunction with complaint control number 18-AS-20200916081046. LPA met with Edgar Gallardo . While completing the investigation for the above complaint, LPA observed documents that multiple incidents occurred that the facility did not report incidents that occurred to community care licensing. Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: 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. 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. This requirement was not met as evidenced by, LPA observed facility documents indicating Resident 1 refused medications on multiple occasions and these incidents were not reported to community care licensing. This poses a health and safety risk to residents in care. A deficiency will be cited. An exit interview was conducted where this report was discussed and provided t o Mr. Gallardo