Incident reportingType B
- Official classification
- Type B
- Official code
- 87211(a)(1)(D)
- Regulation authority
- CCR
What the official deficiency says
87211 Reporting Requirements (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 of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (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, or unexplained absence of any resident. This requirement was not met as evidence by: During the complaint visit dated 6/16/26 LPA observed Incident Reports filed in resident files that were never sent to the department, after conversation with Administrator it was revealed that the incident reports for incidents dated 4/5/26, 6/3/26, 6/4/26, 6/6/26 and 6/10/26 were not sent due to not knowing that it was needed to be sent and LPA received copies of incident reports on 6/23/26 via email. Incident report dated 4/5 detailed a resident hospitalization and Home Health Services, incident report dated 6/4 detailed observations of questionable bruising on a resident and incident report dated 6/10/26 detailed a police investigation regarding alleged physical abuse by staff, which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
Administrator/Licensee to review the regulation cited in its entirety and provide a copy of the completed and signed POC Form LIC9098 as an agreement that the regulation was reviewed and will be followed moving forward. Additionally, a training on reporting requirements is to be conducted with all staff and a copy of the training log with participant signatures is to be emailed to LPA by the POC due date. tena.herrera@dss.ca.gov
Deadline recorded: Jul 16, 2026. A deadline is not proof that correction was completed.