Follow-up on corrections·March 27, 2026

Licensing Program Analyst (LPA) Janet Ngallo conducted an unannounced Case Management - Deficiencies visit. LPA identified herself and discussed the purpose of the visit with Executive Director Tia Suuronen-Goodwin. LPA was at the facility for a complaint investigation, when a violation was found after an interview with staff. LPA requested a records review of the incident report that occurred for R1, who was sent out to the hospital on 02/12/2026 for behaviors, however, interviews revealed that no incident report was written for R1. Records review revealed that R1's incident report was not reported to the department until 03/05/2026. The facility did not submit a written incident report to the department within the required seven (7) days of the occurrence. One deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D pages). A previous citation was issued on 02/04/2026 for the same deficiency. Since the deficiency is a repeat violation within the last twelve (12) months, a Repeat Violation Civil Penalty of $250 was also assessed/charged to Licensee (refer to the LIC421-FC page). An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Executive Director Tia Suuronen-Goodwin whose signature below confirms receipt of these rights.