Incident investigation·April 29, 2024

Licensing Program Analysts (LPA) Kesha Lewis arrived at the facility unannounced for the purpose of conducting a case management incident inspection regarding incident report received dated 01/02/2024 . LPA explained purpose of visit to staff. The incident report was regarding a resident falling and being sent to the hospital with a head injury. The facility fall policy and fall plan for R1 will be emailed to LPA by 2/5/2024. The facility provided a copy of R1'S IPP, discharge paperwork and 602 (Physician's report). LPA conducted facility tour with staff. LPA observed facility common areas, various resident rooms, kitchen area and hallways. Facility was observed by LPA to be clean and sanitary. Floors and walls were clean without prominent stains. Facility was observed to contain no foul odors. Food supply was adequate with 7 days of non-perishables and 2 days of perishable items in place. Fire extinguisher was full charged and current. Room temperature was 71*F. Smoke alarms and carbon detectors are functioning properly. Current census is 7. No obstructions to fire exits noted during today's tour. An exit interview was conducted and a copy of this report was given.