Incident reportingType B
- Official classification
- Type B
- Official code
- 87211(a)(1)
- Regulation authority
- CCR
What the official deficiency says
Reporting Requirements . 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. Based on record review, on 10/22/25 Memory Care Unit R1 had an unwitnessed fall that required 911 emergency assistance. Per file review, an incident report has not been submitted as of today. This poses a potential health and safety risk.
Official plan of correction
Executive Director shall ensure all Unusual Incident Reports are reported to CCL within 7 days of the occurrence of any reportable events. 1. Submit a written Plan of Correction 2. Proof of staff in-service training
Deadline recorded: Nov 14, 2025. A deadline is not proof that correction was completed.