Incident investigation·September 27, 2022

Licensing Program Analyst (LPA) Jamie Ivey Canady arrived at the facility unannounced regarding the incident report dated 9/19/2022 submitted to the Department. LPA Ivey Canady met with Administrator Sherry Richardson and explained the purpose of today's visit. On 09/19/2022, an incident occurred at the facility. There was a resident to resident altercation that resulted in R1 hitting R2 with a can of soda in the mouth. This action resulted in R2 sustaining an injury to the mouth to include bleeding and a swollen lip. According to staff interviews and facility records, staff immediately called 911. The licensee/administrator informed the responsible party and Community Care Licensing within hours of the incident. R2 refused medical assistance of any kind when the police, medics and fire department arrived. LPA Ivey Canady inquired the status of the injured resident and administrator reports R2 is fine and no longer injured. LPA Ivey Canady interviewed R2 and observed no current injury in the mouth area. R2 stated there is no injury. Since the incident, there has been no additional occurrences regarding R1 and R2. Administrator stated residents are never left unattended for more than 5 minute intervals and residents are always walking the halls and visible to staff during the day. LPA Ivey Canady requested and reviewed resident files of R1 and R2. There are no 1:1 designations for either resident. Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit. An exit interview was held, and a copy of the report was given to Administrator Sherry Richardson.