Incident investigation·June 6, 2024

Licensing Program Analyst (LPA) Cuadra arrived unannounced for the purpose of conducting a case management to follow up on three self-incident report filed by the facility to CCL and met with facility Licensee, Angelita Aquino and Administrative Assistant Charito Santos. On 5/24/24 the Department received the first incident report indicating that on 5/21/24 around 5:45 pm resident (R1) approached staff to inform them that they were depressed and had a suicidal thought. Staff called 911 immediately to transport them to the Hospital. Also, the facility notified the responsible parties. R1 was admitted to the hospital for further evaluation and discharged same day with a diagnosed of diabetes with high blood sugar and suicidal thought. R1's case worker came next day to discuss a plan to sign-up R1 into a wellness center or Interlink at least three times per week and case worker agreed to drive R1 to the places. The second incident report, notifies the department that on 5/28/24 around 5:35pm staff observed R1 was anxious and crying, so staff decided to call 911 to transport R1 to the hospital for further evaluation. Responsible parties were notified. During today's visit, LPA was told by Administrative Assistant that the facility had to issue a 30 day eviction letter to R1 dated June 1, 2024 and their responsible party due to behavior and violation of house rules by returning to the facility on 5/21/24 and 5/28/24 dates under the influence of alcohol and/or illegal drugs. R1's records were reviewed by LPA including their care plan, Physician's Report (LIC602) and discharge documents dated 5/21/24 and 5/28/24 with no follow up appointment needed with their Physician. Continues on LIC809C... Continued from LIC809... The last incident report received on 6/4/24 notified CCL regarding resident (R2) who on 5/29/24 around 7:00pm staff and two residents (R3 and R4) witnessed them lighting a glass pipe. Also, R2 was observed by R5 taking their stuff away unstoppable. Staff called the police who came and told the staff that R2 was under the influence and needed to be transported to the hospital for further evaluation, then they receive a diagnosis of methamphetamine abuse and addiction. The facility was referred to call in-response team for future assistance until resident gets relocated to a facility able to meet their needs. Responsible parties were notified. During today's visit, LPA was provided a copy of 30 day eviction letter to R2 dated June 1, 2024 and their responsible party due to violation of house rules by been under the influence of alcohol and/or illegal drugs on 5/29/24. LPA reviewed documents, facility is ensuring that residents (R1 & R2) are closely monitored and supervised by staff for their safety or other's residents health and safety. Based on records review, the facility has taken appropriate measures to address the incidents. Also, eviction notices given to both residents will be reviewed by the Department to determine if they are lawful. No deficiencies cited during today's visit. Exit interview conducted with Licensee and a copy of this report was given.