Incident investigation·August 21, 2024

On 08/21/2024 at 1:24PM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced Case Management visit regarding an incident that was reported to CCLD on 08/07/2024. LPA met with Rose Constantino, Caregiver and explained the purpose of the visit. T he regional office received an incident report stating R 1 had an un-witnessed fall and was found by S1 in the bathroom on the floor, S1 says R1 expressed to staff that he fell down after using restroom and that he was okay at that time. S1 also states the next day R1 started complaining of pain, S1 called 911 and had the resident transmitted to Kaiser hospital for evaluation on 08/07/2024. R1 returned to the community later that night on 08/07/2024 with an After Visit Summary report indicating R1 had a fractured Rib. R1 can transfer and take care of all activities of daily living (ADL's) with assistance. LPA spoke with R1 during visit. R1 stated he fell while in the restroom and landed between the toilet and shower and tried to get himself up from the floor he may have twisted his body wrong which may have cause the fracture to the rib. R1 used his call button for assistance once he realized he wasn't able to get up from the floor without assistance. LPA T. Syess-Gibson collected the following documents: R1’s Physician's Report, After Visit Summary and Appraisal Needs and Service Plan . No deficiencies issued during the visit and a copy of this report provided.