Incident investigation·November 14, 2024

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced case management visit to conduct follow up regarding an incident report. LPA was greeted by, identified herself to, and explained the purpose of the visit with Executive Director Jackie Banks. On 11/5/2024, the Department received an incident report from the facility which described that on 11/1/2024 at approximately 4:45am, Resident 1 (R1) was discovered by facility staff outside in the internal courtyard and had sustained multiple injuries. [Executive Director was provided with an LIC811 Confidential Names List to identify R1] Staff assessed R1 and brought R1 back inside and staff called 911 after R1 was observed to be confused and disoriented. R1 was transported to the hospital where R1 received treatment for the injuries and returned to the facility the same day. During today’s visit, LPA conducted a health and safety check, observed residents in care, including R1, and reviewed and obtained copies of facility records. No deficiencies were cited on today’s date. An exit interview was conducted with Executive Director Jackie Banks, whose signature below confirms receipt of a copy of this report, the LIC811 and the Licensee Appeal Rights (LIC9058 3/22).