Incident investigation·November 9, 2021

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced case management visit to follow up on an incident report/ SOC 341 submitted to Community Care Licensing on 10/07/2021. LPA was greeted and granted entry into the facility by Director of Assisted Living Danica Coronel and explained the reason for the visit. Incident report dated 10/06/2021 indicated Resident 1 (R1) had poked R2 with the residents cane and called the resident "Princess Leah." R1 indicated just joking around. Resident assessed and no injuries noted. During the visit, LPA interviewed both residents. Both residents appear to be happy and well taken care of. Facility spoke with R1 and the resident denied any intent to harm stating the resident was just joking. Facility continues to monitor both residents. Exit interview conducted and a copy of this report will be emailed due to technical difficulties.