Incident investigation·October 25, 2022

Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced Case Management visit - Incident. LPA was greeted and allowed entry into the facility by Staff, Julieta Combes. Administrator, Oliver Calcetas arrived during the visit. LPA discussed the purpose of the visit with the administrator. During today's visit, LPA toured the facility, requested records, and interviewed staff and residents. The administrator self reported an incident involving Resident #1 (R1) that occurred on 08/25/22. R1 sustained discoloration around their eye approximately a half inch by a half inch in size. It is unknown how the discoloration occurred. Staff did not witness an incident involving R1. R1 was transported to the hospital for evaluation and returned to the facility. No deficiencies were observed. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) was provided to Administrator, Oliver Calcetas whose signature below confirms receipt of these rights.