Incident investigation·April 9, 2021

On 04/09/2021 at 12:53 pm, Licensing Program Analyst (LPA) Anna Bui conducted an unannounced Case Management – Incident tele-visit today. Due to COVID-19 health pandemic, LPA met with Marie “Janice” Foronda-Cayabayab, Administrator (ADM), via facetime. The purpose of this visit is to follow up on an incident report that Community Care Licensing (CCL) received on 03/15/2021 regarding a resident (R1) who attempted to hit staff when refusing to make her bed. R1’s LIC 602 (Physician’s Report) and LIC 625 (Appraisal/Needs and Services Plan) were reviewed. R1’s LIC 625 stated that one of R1’s objective is that she will provide staff assistance with tasks. R1’s LIC 625 listed laundry as one of the tasks. R1’s LIC 625 also stated that R1 has an objective to learn to better express her frustration. During today's tele-visit, LPA interviewed 1 resident (R1), 1 staff (S1), and the ADM. During the interview, ADM stated that R1 usually has behaviors during laundry days and does not like to do her laundry. ADM stated that one of R1’s goals involves tasks, such as laundry and folding her clothes, that were agreed upon by R1, R1’s family, and San Andreas Regional Center. R1 agreed to do these tasks but resists doing them. ADM stated that R1’s laundry day was changed to another day, which has helped R1’s behavior. R1 is better at assisting with folding her laundry with the switch in days. No deficiencies were cited during today’s visit. An electronic copy of this LIC 809 was emailed to Marie “Janice” Foronda-Cayabayab, Administrator (ADM), on 04/09/2021 for review and signature.