complaint·February 18, 2022

Interviews and review of facility records revealed that although this incident was unwitnessed by other parties, there was bruising noted to R1’s arm on July 18, 2021. On July 21, 2021, S1 admitted to “grabbing R1’s wrist”. S1 was subsequentl y fired. Interviews with other residents corroborate that there were no other victims and this incident appears to be an isolated event. A review of the facilities medication administration record reveals that medications were administered correctly and that the routine medication that R1 was provided on July 17, 2021 was correct. On July 21, 2021 the facility self-reported the incident to Community Care Licensing, and assisted R1 with filing a police report. During the interview process with R1, the department was able to qualify R1 and R1’s statement was consistent with the report made by the facility to Community Care Licensing. R1 desired prosecution for the incident involving S1 and the police report corroborates the information provided to Community Care Licensing by the facility. Interviews with staff, residents and a review of administrative paperwork reveal that S1 was terminated on July 21, 2021. Based on interviews, and reviewed records, a preponderance of evidence exists to substantiate the allegation. A deficiency is cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). A Plan of Correction was jointly created with the administrator and an exit interview was conducted with Kari Moreno, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 01/16) were provided via e-mail.