Incident investigation·June 8, 2023

Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced case management inspection today, due to an incident that occurred on Thursday, May 25th, 2023. Due to COVID- 19 precautionary measures were taken, appropriate PPE was used. LPA met with Maria Ramirez, Licensee- census was taken. Incident was reported on 6/1/2023- not within the required 24 hours. LPA advised that unusual incident reports have to reported within 24 hours a technical violation was given on this date. Original LIC 624 Unusual Incident/Injury Report form was received by the Department within 7 days. The written incident report was received by email on 6/2/2023. LPA Lopez observed the area where incident occurred and picture was taken. Based on information obtained during this inspection, no follow up is necessary regarding the incident reported. At this time, the facility is in compliance with California Code of Regulations Title 22. No deficiencies cited. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with Licensee Maria Ramirez