Incident investigation·August 9, 2022

Licensing Program Analyst (LPA) Shannan Hansen conducted an unannounced case management and met with Guadalupe "Lupe" Villa-Guerrero, Director of Health Services (DOHS). The purpose of this case management inspection is to follow up on a self reported incident report, SOC 341. CCL received a self report incident report and SOC 341 form on 8/4/2022 reporting on 8/3/2022 staff S1 reported to have witnessed resident R1 trying to hit R2. R2 was able to block R1, and then R1 pushed R2 who fell to the floor. S1 contacted med tech on duty who evaluated finding no injuries. Submitted reports cross reported to Ombudsman and responsible party. LPA informed there had been previous incidents R1 has had with other residents but no physical contact, as staff has been able to redirect R1. Immediately following incident DOHS began working with R1's POA to arrange a 1 on 1 companion. Prior to this altercation R1's POA was working on finding another placement and at this visit LPA has been informed as of 8/8/2022 R1 has moved. No deficiencies cited during today's inspection. New Interim Administrator Camille Brown signed.