Incident investigation·September 7, 2022

Licensing Program Analyst(s) LPA Flores conducted a case management visit to follow up on incident report submitted to the department on 8/31/22 reporting an altercation between Resident #1 and staff #1. LPA Flores met with Matthew Neeley Chief Executive Officer and explained the reason for the visit. On 8/31/22 facility reported to the department via faxed incident report and SOC 341 that on the evening of 8/30/22 resident #1 (R1) had pushed walker, slapped, and threw water at staff #1 (S1). On 8/31/22 Director of Residential Care checked on R1 in the morning and R1 reported that S1 had grabbed R1's arm and left bruises on left arm. On 9/7/22 LPA Flores conducted a case management visit, interviewed Chief Executive Officer, Director of Resident Care and R1. LPA Flores collected copies of R1's physician's report date: 5/20/22 and 5/17/22, admissions agreement, face sheet, appraisal needs and care plan, City of La Verne Police Department business card with report #220900030, and personnel record for S1. S1 is currently off schedule until internal investigation is concluded. No deficiencies were given during this visit. Further investigation is needed at this time. LPA will return at a later time. Exit interview was conducted with Chermaine Williams - Director of Resident Care and a copy of this report was provided.