Incident investigation·August 9, 2023

Licensing Program Analyst (LPA) Hansen arrived unannounced to conduct a Case Management inspection and met with Resident Care Director (RCD) Ashley Perrone & Administrator, Kari Oxford who arrived later. The purpose of this case management inspection is to follow up on an, SOC 341 submitted to Community Care licensing (CCL). CCL received an SOC 341 form on 8/9/2023 reporting on 8/5/2023 outside agency staff (S1) was witnessed by S2, strike resident (R1) on the side of head with a closed fist. Facility contacted Law Enforcement who took custody of S1 and removed from facility. Facility is full dementia. During today's inspection LPA was informed by Administrator & RCD that S1 worked at the facility on call since April, 2023. LPA informed Administrator & RCD that S1 is not associated to facility and should never be working and providing care to residents prior to a criminal record clearance or exemption * **Civil penalties are being assessed in the amount of $100 per day for allowing a person to work, reside or volunteer in the facility without a fingerprint clearance/transfer per two weeks for a total of $500. LPA conducted interviews, obtained records, and advised facility to submit a copy of police report when received. LPA will review information, conduct additional interviews and follow up with facility. Appeal of Rights Given. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.