Follow-up·July 18, 2024

Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 07/18/24 to do case management visit. LPA met with Assistant Director, Tosha Devi and explained the purpose of the visit. Incident for resident, R1- During complaint investigation ( 59-AS-20240228115229 ), LPA learned that resident, R1 was sent to hospital /ER due to Fall Incidents on 07/20/23 and on 10/12/23. Furthermore, R1 has been placed in Skilled Rehab Facility with diagnosis of trauma to left hip around 06/26/23 till 07/19/23. All these incidents for R1 should have been reported to Department as required per Title 22 Regulation, 87211 within 7 days but facility did not comply with this reporting requirement. Incident for resident, R2- During complaint investigation ( 59-AS-20240624153835 ), LPA learned that resident, R2 had AWOL incident on 06/23/24 around 9am and R2 was found in their wheelchair 0.5 mile away from the facility unattended and unsupervised by law enforcement who notified the facility around 10am regarding R2’s AWOL incident. Although, R2 was found uninjured, R2 was sent to local hospital under 51/50 hold. This incident for R2 should have been reported to Department as required per Title 22 Regulation, 87211 within 24 hours but facility did not comply with this reporting requirement. Based on the records reviewed and information gathered, it has been determined that the facility did not report these incidents for residents R1 and R2 to Department as required. Based on this information, citation has been issued per Title 22 Regulations as indicated on 809-D. Exit interview conducted. Appeal Rights and copy of this report has been provided.