Incident investigation·March 18, 2024

At approximately 9:40AM, Licensing Program Analysts (LPAs) Felias and Florio arrived unannounced to conduct a Case Management - Incident Visit and met with Administrator, Rufus Zingkhai. The purpose of today's visit is to follow up on self-reported incidents that were submitted to Community Care Licensing (CCL). Incident Report 1: CCL received an incident report on 02/26/2024. Report stated that on 02/21/2024, Facility observed an anal fissure on Resident 1 (R1). Facility contacted 911 and Home Health Nurse and R1 was transported to the hospital for evaluation. Facility made all appropriate notifications per regulation. Incident Report 2/SOC-341: CCL received an incident report and SOC-341 on 03/12/2024. Reports stated that on 03/11/2024, R1's Responsible Party reported to staff that R1 could have had forced trauma injuries to their rectal area. Facility made all appropriate notifications per regulation. LPAs requested and reviewed documents. No Deficiencies cited during visit. Exit interview conducted. Copy of report and LIC811 (Confidential Names) discussed and provided to Administrator. Signature on form confirms receipt of documents.