Incident investigation·May 12, 2022

Licensing Program Analyst (LPA), Sandra Urena conducted an unannounced Case Management-Incident visit to obtain additional information surrounding an incident that occurred on 05/07/2022. The LPA met with Executive Director (ED) Ralph Balbin at 1:25 p.m. and explained the reason for the visit. The reason for today's inspection is to follow up on a self-reported incident received on 05/09/2022. The report pertains to Staff #1(S1), regarding an alleged incident which occurred on 05/07/2022, at around 11:00 a.m. S1 was observed by a Witness(W) striking Resident #1(R1) on the hand, and rubbing R1’s face in a manner that caused R1 discomfort. The LPA interviewed the witness, Staff#2(S2), and Staff#3(3) from 12:05 p.m., to 1:00 p.m. The LPA also reviewed records, and obtained copies of pertinent documents. No health and safety concerns noted at this time. Further investigation is needed prior to issuing findings. Exit interview conducted with Executive Director, Ralph Balbin. Signatures obtained. A copy of report was issued.