Incident investigation·May 16, 2023

Licensing Program Analyst (LPA) Cuadra arrived unannounced and met with Administrator, Ric Pielstick to conduct a case management inspection regarding a recently self-reported incident at the facility, which resulted in a suspected physical abuse report. Two incident reports were received at CCL on 5/11/2023 along with SOC 341. The incident occurred on 5/6/21 after dinner when staff heard a loud smack, turned around and noticed resident (R1) walking away from resident (R2). R2 was assessed by staff who observed that R2's face appeared red and sustained a skin tear on their arm. According to the facility, this is not the first attempt of this type of incidents have happened between both residents. they have notified R1's responsible party and advised them to spend some time to observe R1's behavior which they did came to the facility for approximate two weeks between 5pm-8pm when most of the aggressive behavior towards R2 have been observed. R1's room is located directly across from R2's room. The facility have offered R1's responsible party another vacant room that is not in direct sight from R2's room. However, R1's responsible party have declined the offer. During today's visit, LPA conducted confidential interviews with staff and reviewed documents. Based on records review of R1's physician's report (LIC602) dated 6/26/22 indicates that R1 have a diagnosis of dementia without behavioral disturbance. However, R1's care plan dated 4/12/23 reflects that R1 has combative episodes that facility have notified R1's physician as indicated in documentation provided by the facility which resulted in an increase of certain medication related to behaviors. After incident, law enforcement was contacted and they came to assess the situation and could not obtain evidence to move forward with this incident. On 5/12/23 CCL have received a 3-day eviction notice issued to R1, LPA discussed with Administrator the severity of the situation which it was determined and agreed that 3-day eviction notice will be discarded, the facility will issue a 30-day eviction notice. Although, there is another facility that has assessed R1 and will be relocating them to their community. In the meantime, the facility is attempting to prevent further incidents by providing one on one staff from 7am to 9pm to assist with R1's care needs. No deficiencies cited during this inspection. Exit interview was conducted with Administrator and a copy of this report was given.