Follow-up·January 26, 2024

Licensing Program Analyst (LPA) Dawn Segura conducted a case management visit to cite for a deficiency observed during a previous visit. LPA introduced herself, was granted entry and met with Chona Simsuangco, Licensee, who arrived a short time later and with whom she discussed the purpose of the visit. During today's visit, LPA conducted a tour of the facility, reviewed and obtained copies of facility records, and spoke with staff. LPA’s observation and information provided by licensee and staff today and during previous visit revealed that Resident 1 (R1) is bedridden and unable to reposition independently. Review of the facility's license and fire clearance revealed that the facility is cleared and licensed for non-ambulatory residents. The facility does not have an approved fire clearance to house a bedridden resident. Based upon the foregoing, a deficiency is being cited Per Title 22, Division 6, Chapter 8 of the California Code of Regulations and is listed on an LIC 809-D. A civil penalty in the amount of $500 is being assessed on an LIC 421IM. An exit interview was conducted with Chona Simsuangco at the end of the visit. Copies of this report, LIC 421IM, LIC 811, and Licensee/Appeal Rights (LIC 9058) were provided to the licensee, and her signature on this form acknowledges receipt of copies of the documents.