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13 | Licensing Program Analyst (LPA) Daiquiri Boyd conducted the subsequent complaint investigation visit to the facility. During the course of this complaint investigation LPA interviewed staff, Administrator, and resident, as well as obtain relevant resident cell phone documentation. It was determined based on the interviews, verification of phone information, and timeline and outcome of events on 6/10/2025, that the above allegation is SUBSTANTIATED. A series of events between staff and resident led to staff placing a phone call to a resident's cell phone at 11:19pm. The verification of the call being recieved, as well as the time of night it was placed, resulted in resident feeling intimidated. Facility did not report the initial event between staff and resident to Licensing within 7 days. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 & Chapter 8), are being cited on the attached LIC 9099D.
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| Substantiated | Estimated Days of Completion: |
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Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Under Appeal
Type B
11/06/2025
Section Cited
CCR
87468.1(a) | 1
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7 | (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:... This requirement was not met as evidenced by interviews of S1 and R1 R1's cell phone log shows R1 received a call from S1 at 11:19pm. R1 said S1 yells and intimidates residents. Based on the | 1
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7 | Facility will rettrain staff at facility on personal rights and send proof with staff signatures and date of the training by 11/6 to Licensing. |
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14 | interaction of S1 and R1 on 6/10/25, followed by removal of staff, and call log showing the received call and time of night S1 called R1, R1's Personal Rights were violated. S1 did place a call to R1 at 11:19pm, which poses a potential risk to the health, safety, or personal rights risk to the residents in care. | 8
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Under Appeal
Type B
11/06/2025
Section Cited
CCR
87211(a)(1)(D) | 1
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7 | (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence... | 1
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7 | Administrators to read and provide statement that Reporting Requirement regulations have been read and are understood. Proof with dates and signatures to be provided to Licensing by 11/6. |
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14 | (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents...This requirement is not met as evidenced by the facility did not submit an Incident Report to Licensing within seven days. Incidents occured on 6/10/25 and were not reported until 6/20/25, which poses a potential risk to the health, safethy, or personal rights risk to the residents in care. | 8
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