Incident investigation·December 6, 2021

Licensing Program Analyst (LPA) Alviso, conducted a Case Management Incident Inspection on 12/6/21 at approximately 11:30, and met with Sam Ambrecht lead caregiver/Administrator Assistant. LPA was screened for covid symptoms, and temperature was taken, before LPA was allowed to stay in the facility. LPA advised facility staff to use a covid symptoms questionnaire of some kind such as the CDC's covid symptom questions to be asked of each person, individual, staff, and residents, entering the facility. Sam Ambrecht, caregiver printed out copies of the form from the CDC website and immediately put them out on the screening table to be used. LPA reviewed resident incident, and discussed the incident with staff. LPA met with the resident in care. LPA has received documentation and information from the administration staff regarding the incident and all follow-up. Administration staff addressed the incident, notified all required party(s), and completed required reporting. Administration staff will keep Licensing updated as needed and required. Administration staff will ensure the resident's current needs are met; Administration staff will ensure that the facility can meet all resident's care needs. No deficiencies cited today.