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25 | On 09/28/2023 at 2:30 PM, Licensing Program Analyst (LPA) Pang Lee arrived at facility unannounced to
conduct a case management visit. LPA met with direct care staff, Eliesa Qiolele and explained the purpose of the visit. The census is 6 with 2 care staff. Administrator Ratu Vunimatanu was not present during today's visit.
The purpose of this case management is due to learn deficiencies during complaint investigation with complaint control number 27-AS-20230814135530. LPA Lee toured the facility and checked on residents’ welfare. On 08/29/2023 during complaint visit LPA Lee observed the resident door #3 has a hole. It was learned that resident 1 (R1) kicked (R1) door causing a hole on 08/07/2023. On 08/29/2023, it was learned from care staff that administrator is aware of the hole in resident door #3 and will replace it. During today's visit 09/28/2023 at 2:30 PM, LPA Lee observed resident door #3 still have a big hole. The hole has not been repaired or replace.
The following deficiency was observed and cited from the California Code of Regulations, Title 22, and California Health and Safety Code. An exit interview was conducted, and a copy of the appeals rights, LIC 809 report, and LIC 809-D page was given to the facility. |