Incident investigation·July 19, 2022

On 7/19/2022 Licensing Program Analyst (LPA) Murial Han conducted an unannounced follow-up visit to deliver the outcome from the case management visit on 6/20/22 concerning an incident that was reported by the facility on June 3, 2022. On June 3, 2022, CCL received a LIC624 (Unusual Incident/Injury Report) from the facility regarding resident #1 (R1) was delivering mail to resident #2 (R2) and was told by R2 not to touch the mail that does not belong to R1. R1 appeared upset, left the facility and went to a nearby store where R1 was witnessed by a bystander performing an unusual activity which triggered the bystander to call 911. In addition, the bystander also called the facility to confirm R1 was a resident at the facility. Based on the documents provided by the facility, R1 is able to leave the facility unassisted, and according to staff, R1 enjoys to walk outside of the facility and returns when R1 is ready. Concerning to resident's mail, staff stated that facility has a system to ensure mails are delivered to the residents on the day as they arrive. However, the mails were delivered late on the day prior to the incident and they were left on the receptionist desk. On the next morning, R1 got hold of them, took the mails that belonged to R2 and delivered them to R2 as a nice gesture but it was not appreciated by R2 which made R1 upset and left the facility. The staff also reported that there was no alteration between R1 and R2. Based on record review and interviews, no deficient cited. This report is reviewed and discussed with the administrator. A copy is provided.