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32 | During interviews conducted with relevant parties, it was determined that staff members are not properly trained for emergency disasters. Facility staff did not appropriately follow emergency procedures when the fire alarm activated on November 10, 2025. The facility is not in compliance with Section 101216(a) - Personnel Requirements.
Based on the evidence obtained, including interviews and the admissions of S1 and S2, it was determined that staff are not properly trained for emergency disasters. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.
There was one (1) Type B deficiency cited during today’s visit in accordance with the California Code of Regulations, Title 22, Division 12, and Chapter 1. See LIC 9099-D for additional information.
An exit interview was conducted, and Plan of Correction was reviewed and developed with Licensee/Director Shirani Perera. A copy of this report and appeal rights were discussed and left with the Director, whose signature on this form confirms receipt of these documents.
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