Incident investigation·November 12, 2025

On 11/12/2025 at 1:20 PM, Licensing Program Analyst (LPA) P.Manalo conducted an unannounced Case Management visit regarding a self-reported incident. The facility sent in an incident report on 10/21/2025 regarding R1's fracture. LPA met with Executive Director, Gianni Amari, and explained the purpose of the visit. LPA P.Manalo received a self-reported incident report from facility that indicated Resident 1 (R1) had unwitnessed fall on 10/12/2025. R1 was sent to the hospital and was treated for a clavicle fracture. During the visit, LPA reviewed R1's Service Plan dated 05/31/2025, 10/17/2025, and 10/29/2025, Physician Reports, and After Visit Summary. A review of R1's Physician Report dated 10/30/2025 revealed that R1 has a diagnosis of osteoporosis. LPA requested for facility to send the full after-visit summary by 11/21/2025. No deficiencies cited during visit. Exit interview was conducted with Amari and a copy of this report was provided.