Incident investigation·March 27, 2024

On 3/27/2024, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a case management visit regarding an incident LPA observed from incomplete annual inspection on 3/14/2024. LPA met with Licensee, Neal Torres, and explained the purpose of the visit. LPA was informed that R1 was sent to the emergency room as there was an error on R1's oxygen machine. Licensee stated the machine has stated oxygen level at 88, but once fire department arrived, their machine was reading level at 96. Licensee continued that when emergency medical services arrived, their machine was reading oxygen level another inconsistent level. Licensee stated R1 was transported with emergency medical services to the emergency room to ensure their health and safety. LPA was informed R1 now has a new oxygen machine. LPA and Licensee discussed submitting incident reports, LIC 624, in a timely manner as it is required. LPA provided Licensee a copy of Title 22, California Code Regulation 87211 Reporting Requirements. No deficiencies cited. Exit interview conducted and a copy of report was provided.