Follow-up on corrections·May 5, 2026

Licensing Program Analyst (LPA) Kristin Kontilis conducted a Case Management visit to address deficiencies noted during Complaint Control #29-AS-20260030911520. The Case Management visit is being conducted to address CCLD’s concerns that were observed during the course of the investigation. LPA Kontilis met with Administrator Robert Glock and explained the purpose of the visit. During the complaint investigation, interviews conducted and records reviewed revealed Resident 1 (R1) self-admitted into the hospital on 2/20/2026 and returned to the facility on 3/2/2026. On 3/20/2026, an incident occurred wherein R1 was admitted into the hospital as a result of a 9-1-1 call while R1 was out of the facility. After the 3/20/2026 incident, R1 did not return to the facility. As a result of the 3/20/2026 incident, R1 was issued an eviction notice dated 3/21/2026 stating the facility could no longer provide the level of care and/or a safe environment for R1. Record review revealed a copy of the 3/21/2026 eviction letter was not received by Community Care Licensing Division (CCLD) as required in California Code of Regulations (CCR). Administrator Glock acknowledged the eviction letter was sent to R1, however the letterhead of the notice does not bear the full address nor the facility number on the letter. Administrator acknowledged there is no record of the eviction letter being sent to CCLD. Further record review revealed a Serious Illness/Serious Injury incident report was not received by CCLD as required reporting R1’s self-admission into the hospital on 2/20/2026. Administrator acknowledged there is no record of an incident report being sent to CCLD since R1 self-admitted into the hospital on 2/20/2026. Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted. Copy of report and Appeal Rights issued via email.