Follow-up on corrections·August 12, 2024

Licensing Program Analyst (LPA) Martha Arroyo conducted a Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint Control # 29-AS-20240703104847). The purpose of the visit is to issue a citation for a deficiency observed during the complaint investigation. During the complaint investigation of complaint # 29-AS-20240703104847, the following deficiency was observed: On 06/13/2024, Resident #1 (R1) had an unusual incident while at the facility where it states that around 8:50 a.m., caregiver on duty reported that R1 was agitated and banging their head on the wall while yelling and screaming. The caregiver reported that R1 sustained a bruise on their right forehead. On 07/09/2024, Incident report pertaining to R1 was provided to LPA; however, incident report was not reported to the Department prior to the visit as there was no documentation to show proof indicating that they submitted within the seven (7) days of occurrence as required by the California Code of Regulations. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.