Incident investigation·May 10, 2024

Licensing Program Analysts (LPAs) Steve Chang and Manuel Monter conducted an unannounced case management- incident visit and met with Executive Director (ED) Shantela Yadao. On 5/10/24, the Department received an incident report from the facility that on 5/7/24 at noon, the facility fire alarm and fire sprinkler system was activated in the AL unit on the 3rd floor. Fire Department (FD) responded upon activation of fire alarm in the facility. FD determined that R1 was burning a paper and it got out of control. No major fire damage reported other than R1's door frame in the bathroom and walls were black due to smoke. R1's apartments next door as well as below on 2nd and 1st floor were all affected as water leaked below and hallways. All residents were having lunch when the incident happened. All residents including R1 were evacuated out of the facility safely. No injuries and/or hospitalization reported. No known media attention. LPAs toured the affected rooms 121B, 251, 334, 337 and 339. The rooms were used fan to dry out the water. ED stated the rooms will be back to normal on 5/13/24 Monday. LPAs interviewed resident R1. R1 denied he/she made the fire. R1 stated he/she did not know what happened. ED stated the facility took R1's lighters and update R1's care plan. LPAs requested R1's physician report, Appraisal Needs and Service Plan. ED stated no one got injury. ED stated the facility will update CCL office. ED stated he/she will send follow up action plan to LPA. Exit interview was conducted with ED. The report was provided to ED for signature.