Incident investigation·December 23, 2021

Licensing Program Analyst (LPA), Kristina Ryan, conducted an unannounced case management visit to follow up on a SOC 341 received on December 20,2021. LPA Ryan introduced herself, stated the purpose of the visit, was allowed entry and met with Executive Director, Foudhil Manadi. Community Care Licensing (CCL) received a SOC 341 on December 20, 2021, which stated that a resident had an incident with a staff. Licensee informed all of the relevant parties of the incident. During today's visit, LPA reviewed resident and staff records, and interviewed staff and residents. Executive Director was informed that this investigation into this incident requires more time and future visits may be needed. No deficiencies were cited at this time. An exit interview was conducted with Mr. Manadi. A copy of this report, along with the Licensee Rights (9058 01/16) was emailed to the executive director at the conclusion of the visit, an electronic response confirms the receipt of these documents.