Follow-up·April 28, 2022

At approximately 10:15AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Case Management visit and met with Administrator, Mikayla Muehleisen. The purpose of this Case Management visit is to follow up on a self-reported incident submitted to Community Care Licensing (CCL) by this facility. LPA spoke with Administrator regarding a resident's fall that occurred on 4/16/2022. Incident report states that Resident 1 (R1) tripped over a serving tray in the dining room resulting in a skin tear to their right leg. Resident refused for 911 to be called for further evaluation and Medication Technician bandaged wound. Family and Physician were notified. Family took resident to the ER on 4/17/2022 for further evaluation. LPA and Administrator discussed Fall Protocol, First Aid Training, and how staff will ensure that passageways in facility are not obstructed to reduce fall risks. LPA and Administrator also discussed putting more details into Special Incident Reports/SIRs that are submitted to CCL. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties.