102416.2(a) · 102416.2 Reporting Requirements (a) The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm).

Per licensee, she never thought that receiving assistance from the Montebello Police Department (MPD) on 04/13/26 required for her to report it to the department within 24 hours. Per licensee, the MPD did not provide a report or anything and left the premises. Licensee will complete and submit the LIC 624B by POC due date. Licensee did not notify the department of an incident involving the Montebello Police Department that occurred on 04/13/26 to the within the required 24 hours which poses a potential health, safety or personal rights risk to persons in care. Ana Chico NAME OF LICENSING PROGRAM MANAGER: Veronica Martinez-Garza NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/02/2026 I acknowledge receipt of this form and understand my appeal rights as explained and received.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.