Incident investigation·March 3, 2023

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management visit. LPA was welcomed by and identified himself to Caregiver Lucy Credito. LPA then met and discussed the purpose of the visit with Licensee Siera Navasak. Today's visit was in response to an LIC624 Unusual Incident/Injury Report, which licensee self-submitted to the CCLD San Diego Regional Office on 02/23/2023, involving Resident #1 (R1) and Staff #1 (S1). [See LIC 811 Confidential Names List for a description of person identifiers used in this report]. During today’s visit, LPA performed facility tour / welfare check, interviewed 6 of 6 residents in care, interviewed staff, and collected records. No deficiencies were observed or cited during today's visit. An exit interview was conducted with Navasak, to whom a copy of this report, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.