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32 | Second allegation: Staff did not seek timely medical attention for resident in care. Regarding the allegation stated above, LPA conducted a file review pertaining to Resident #1. Upon the review of record LPA observed a death report to be on file for Resident #1. Based on death report Resident #1 passed away on 12/28/2024, death report indicated that fire department was contacted and life saving measures were initiated to R#1 however, upon the review of staff statements, statements show that staff found R#1 in residents room with no signs of life. Based on the evidence gathered during the investigation, the above allegations are Substantiated. A finding that the complaint is Substantiated means that the findings are valid because the preponderance of the evidence standard has been met. Title 22 Regulations, Unlawful False Claims 87207, Personnel Requirements – General 87411 (a), from division 6, chapter, article 6, is, cited on the attached LIC 9099 D. An exit interview was conducted where this report, appeal rights, and LIC9099-D were discussed, and a copy of the report was provided to Facility Administrator Jennifer Uriza at the conclusion of the visit. |
Deficiency Type
POC Due Date /
Section Number | DEFICIENCIES | PLAN OF CORRECTIONS(POCs) |
Type A
06/22/2026
Section Cited
CCR
87207 | 1
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7 | 87207 False Claims
No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.
This requirement is not met as evidence by | 1
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7 | The Licensee has agreed to read over regulation: False Claims 87207 and provide training to all staff and provide LPA with a statement of understanding. During review of record LPA observed that disciplinary action was issued to staff and staff was terminated on 4/13/25. The Licensee will provide LPA with training by POC date 6/22/26. |
 | 8
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14 | Based on record review, the licensee did not adhere to regulation by falsifying/altering Resident #1 records, which poses an immediate Health, Safety, or Personal Rights risk to persons in care. | 8
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14 | |
Type A
06/22/2026
Section Cited
CCR
87411(a) | 1
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7 | Personnel Requirements – General 87411 (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services.
This requirement is not met as evidence by | 1
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7 | The Licensee has agreed to read over regulation: Personnel Requirements – General 87411 (a) and provide training to all staff regarding the importance of observing and reporting residents change of conditions and provide immediate medical assistance. The Licensee will provide LPA with training by POC date 6/22/26. |
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14 | Based on record review, the licensee did not adhere to regulation by not seeking R#1 with medical attention in a timely manner before R#1 death, which poses an immediate Health, Safety, or Personal Rights risk to persons in care. | 8
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14 | |