Incident investigation·October 3, 2023

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced for the purpose of conducting a Case Management-Incident inspection to discuss three incidents that were reported by the facility to CCL, and to also Amend a Report that was issued on August 30, 2023 in which a Type A deficiency was issued. Facility appealed, and CCL determined that a Type B deficiency is warranted instead. LPA changed the deficiency from a Type A to a Type B deficiency (See LIC 809-Case Management-Incident inspection dated for August 30, 2023) CCL received an incident report on September 20, 2023 indicating a residents jewelry went missing. Administrator contacted the appropriate parties which includes the Responsible Party via email. LPA requested the following documents: -LIC 602 CCL received an incident report on September 25, 2023. Resident had a left hip fracture due to falling off a chair that was placed in his apartment. Administrator contacted the appropriate parties which includes the Responsible Party. Resident was not a fall risk and there were no prior fall incidents regarding this resident. Facility will reassess resident and determine what additional needs (if any) are needed for this resident. CCL received an incident report indicating a fall that occurred on September 27, 2023 indicating that there was one rodent (rat) that was an apartment. Administrator cleaned, fumigated and eradicated the room. In addition, facility hired a pest control company to ensure that there was no rodent infestation. LPA requested the following document: -Eco-Lap pest control receipt No deficiencies were observed or cited during today's Case Management-incident inspection. Exit interview was conducted and a copy of this report was given to the Administrator.