Incident investigation·April 8, 2021

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced case management visit. Due to COVID-19 restrictions, it was conducted via video telephone call. LPA identified himself and stated the purpose of the visit to facility administrator John Brennan. The facility self-reported an incident about unwelcome verbal comments and touching between Staff Member 1 (S1) and Resident 1 (R1) that occurred on 04-05-2021. The incident report stated that S1 was suspended pending investigation. On today’s date, LPA briefly toured the facility, conducted a welfare check on R1, interviewed the administrator, and requested relevant care and administrative records. No deficiencies were cited during the visit. An exit interview was conducted with the administrator, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided via E-mail. An electronic read receipt confirmation was requested from the administrator upon receipt of documents. [See LIC811 Confidential Names list to identify Resident 1 and Staff 1].