Incident investigation·December 16, 2021

This unannounced case management visit is being conducted by Licensing Program Analyst (LPA) Ruth Martinez to follow up on an incident reported to Community Care Licensing. LPA arrived at facility was greeted at the door by caregiver and granted entry. LPA met with Jennifer Suckiel , administrator and explained the purpose of today’s visit. Incidents were self-reported on 12/07/2021 regarding R1’s incidents on 11/28/2021. On 11/28/2021 R1 was using the restroom in R1's apartment, R1 was sitting on the toilet when resident slid to the side into the walk in shower. R1 pressed EMS and EMT on duty responded to the call. R1 complained of pain to shoulder and 911 was called. Paramedics arrived to evaluate and treat R1, resident was transported to hospital for evaluation. All responsible parties were notified and R1 returned to the community and is in the skilled nursing section of the facility. R1 referred to skilled nursing for post fall rehabilitation. R1’s care plan does not require bathroom assistance as R1 is not a fall risk resident. LPA found that facility acted appropriately and in a timely manner to address the incident and all other immediate attention to injuries in question. LPA did not observe any immediate and/or safety risks in or out of the facility. Based on the observations made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations . This report was reviewed with Jennifer Suckiel , Administrator and a copy of this report was provided and left at the facility.