San Carlos Elms

FACILITY EVALUATION REPORT

The inspection was conducted to review the facility's Hospice waiver request. The Licensing Program Analyst reviewed facility sketches and fire clearance, noting that while the facility can accommodate 9 bedridden persons, the current documentation does not specify which rooms are approved for this purpose. The department will follow up by submitting a request for an updated fire clearance inspection.

The facility underwent an Annual 1-year required inspection on May 2, 2025. The Licensing Program Analyst reviewed resident records, staff files, and centrally stored medications, finding everything to be complete and properly labeled. No deficiencies were cited during the visit.

The facility underwent an Annual 1-year required inspection on April 25, 2025. The inspection covered the physical plant, including rooms and common areas. No deficiencies were cited during this visit, and the facility was found to be compliant with observed standards.

The unannounced annual visit on 5/31/24 found the facility to be in good operational condition. The evaluator noted that resident records are updated, staff records are complete, and all safety and care measures, including fire safety and emergency drills, appear to be in place. No deficiencies were cited during this inspection.

The facility underwent an unannounced case management incident visit on May 17, 2024. The report details an incident that occurred on May 14, 2024, involving a resident's passing. Crucially, the narrative explicitly states that no deficiencies were cited during this inspection.

This Case Management visit followed up on a substantiated allegation of physical abuse involving two residents (R1 and R2) by a staff member (S1). The report details that the department is issuing a substantial civil penalty ($19,500.00) for physical abuse, citing violations related to resident rights and proper care/supervision. The facility was previously cited for violating CCR Title 22, § 87468.1(a)(2) stemming from this incident.

FACILITY EVALUATION REPORT