Incident investigation·May 20, 2022

On 5/20/2022, Licensing Program Analyst (LPA) Murial Han conducted an unannounced Case Management visit concerning a serious incident that was reported by the facility. LPA met with administrator, Christina Spence and health services administrator, Ryan Banner and explained the purpose of the visit. On 5/14/2022, facility reported a serious incident that took place on 5/14/2022 concerning resident #1 (R1). During today's visit, LPA requested for the following documents for R1: - LIC 602 (Physician's Report)- will email by noon of 5/23/2022 - Service Plans- will email by noon of 5/23/2022 - Recent Hospital Records - will email by noon of 5/23/2022 LPA collected the following documents during the visit: - Facility care staff work schedule - Security officer work schedule for 5/13/2022 - 5/14/2022 This incident requires further investigation. This report is reviewed and discussed with administrator. A copy is provided.