Incident investigation·April 4, 2024

On April 4, 2024, Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced case management visit at the facility. LPA was greeted by Sheryl McCaskill Operation Specialist and granted entry after identifying herself. LPA met with Sheryl McCaskill Operation Specialist and explained the purpose of the visit. The facility self-reported an incident to Community Care Licensing on March 21, 2024 regarding an incident that occurred on March 19, 2024. Reporting indicated that Resident 1 (LIC811 Confidential Names list provided to Administrator to identify R1) had an unwitnessed fall which resulted in a change in condition. R1 refused to go to the hospital the day of the fall on March 19, 2024. On March 20, 2024 at 1:15 pm R1 was sent by ambulance to the hospital for further evaluation and treatment. During today’s visit, LPA conducted a Health and Safety check of R1 and requested facility records. No deficiencies were cited at this time. An exit interview was conducted with Sheryl McCaskill Operation Specialist and a copy of this report and Licensee/Appeal Rights (LIC 9058 03/22) was provided.