Incident investigation·July 25, 2024

On 7/25/2024, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a case management visit regarding the LIC 624 Unusual Incident/Injury Report the Department received. LPA met with new Executive Director, Deborah Taylor, and Regional Director, Davina Barker, and explained the purpose of the visit. The incident occurred when R1 was eating lunch in the common dining room when S1 observed R1 to be choking. S2 then helped dislodged meat out of R1's throat. R1 was sent out for evaluation. Incident report stated primary care physician was notified. R1 returned to the facility with no changes. LPA and Regional Director discussed and confirmed that R1's responsible party was notified via "voice to voice". It was further discussed that R1 was not on special diet but after the incident, R1 is now on a new order of mechanical soft diet. Facility reported no staffing issues and/or additional concerns. As a result of today's visit, no deficiencies cited. Exit interview conducted an a copy of the report provided.