Incident investigation·March 15, 2023

***Amended on 03/16/2023 due to: the report being filed under the wrong facility number*** Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management visit and met with Saaj Kaiyom. The purpose of the visit was to conduct a safety check on the facility after it was reported that a tree had fallen on the facility building. During visit, LPA Marrufo toured the facility. LPA Marrufo observed the outside patio area where a cluster of trees had fallen. LPA observed the outside patio and roof to have impact damage from the trees. A crew of workers was on site removing the tree. LPA Marrufo photographed the impact area as well as the remains of the tree. Mr. Kaiyom reported that there were no injuries from the fallen trees. LPA Marrufo observed that the door to the wing of the facility that is located near the impact area had a sign posted from the County of Santa Cruz stating that the area beyond the door was under restricted use. The residents who resided on the impacted wing of the building were relocated to other parts of the facility. LPA Marrufo observed two male residents relocated to the living room. One female resident was observed to have been relocated to a vacant bedroom on the opposite side of the building. Another female resident had her bed relocated to the recreation room. Mr. Kaiyom confirmed that those four residents, two male and two female, were the only residents who had to be relocated to the other side of the building. LPA Marrufo observed the resident medications and staff and resident records to be relocated in another room in the building away from the impacted area. LPA Marrufo advised Mr. Kaiyom to submit an Unusual Incident Report for the fallen trees. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Mr. Saaj Kaiyom and a copy of the report was provided.