Standard 102416.2(b)(1)
MinorBased on record review and information obtained, the unusual incident occurred on May 12, 2026, and the licensee did not report the incident to Licensing until May 18, 2026, which posed a potential health, safety, or personal rights risk to persons in care.
A correction plan is recorded. No state verification date is shown.
Recorded plan of correction
Licensee shall ensure to report unusual incidents to the Department within the Department’s next business day and during normal working hours. The licensee will also provide a written statement confirming acknowledgment of the reporting requirement regulation and submit proof to Licensing by 08/10/2026. Cynthia Brannon Xona Xayavong DATE: 07/27/2026 DATE: 07/27/2026 Page: 3 of 3
Standard 102416.2(b)(1)
- State severity
- Type B
- Corrected at visit
- Not recorded
- Correction due
- Aug 10, 2026
- Technical assistance
- Not recorded
- Finding source ID
- ca:165620175:2026-07-27:102416.2(b)(1):1
- Visit source ID
- ca:165620175:2026-07-27:other