Follow-up·October 10, 2022

Licensing Program Analyst(s) (LPA) Mary Flores conducted a case management visit to follow up on initial case management visit conducted on 9/7/22 regarding incident report submitted to the department on 8/31/22. LPA Flores met with Desiree Eudave LVN and explain the reason for the visit. On 9/7/22 LPA Flores conducted a case management visit to follow up on incident report submitted on 8/31/22 to report an altercation between Resident #1 and staff #1. 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 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. On 9/15/22 LPA Flores conducted an interview with S1 over the phone and reviewed R1's documents. On 10/10/22 LPA Flores attempt to contact R1's representatives and left a voice message. No further investigation is needed at this time. No deficiencies have been noted during this visit. Exit interview conducted with Desiree Eudave LVN and a copy of this report was provided.