Follow-up·June 13, 2025

Licensing Program Analyst, Teresa Camara arrived on June 13, 2025, for an unannounced inspection to follow up on a substantiated allegation of a complaint investigation (complaint control number 29-AS-20210226132843). LPA met with Clinical Director Davi Rivas, RN. On February 24, 2022, the Department concluded a complaint investigation regarding the following allegation: Resident #1 (R1) sustained multiple fractures while in care. The licensee was cited for Health and Safety Code §1569.312 Basic Services Requirements . At the time of the complaint visit on February 24, 2022, an immediate civil penalty of $500 was issued and the licensee was informed that an additional civil penalty might be assessed based on Health and Safety Code § 1569.49(f). The Department has concluded an analysis and has determined that a civil penalty is warranted for serious bodily injury. The Welfare and Institutions Code Section 15610.67 defines serious bodily injury as “an injury involving extreme physical pain, substantial risk of death, or protracted loss or impairment of a function of a bodily member, organ, or of mental faculty, or requiring medical intervention, including but not limited to, hospitalization, surgery, or physical rehabilitation.” This is evidenced by the facility not providing proper care and supervision for R1 that resulted in multiple fractures from multiple falls. (continued LIC809C, page 2) (continued from LIC809, page 1) Today, June 13, 2025, the Department will be issuing a civil penalty per Health and Safety Code § 1569.49(f) for a violation that the Department constitutes as serious bodily injury in the amount of $10,000. However, since an immediate civil penalty of $500 was previously issued on February 24, 2022, the amount of the civil penalty issued today will be $9,500. Exit interview conducted. A copy of the report issued. Appeal rights provided to Clinical Director David Rivas, RN and signature on this report acknowledges receipt of the appeal rights, found on page two of LIC 421D.