Incident investigation·May 11, 2023

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced Case Management – Incident visit for the purpose of following up on a self-reported incident that occurred on 05/08/2023. LPA initially met with Business Office Director Kailey Vanderwall. Executive Director (ED) Bradlee Foerschner arrived at 09:00AM. LPA explained the reason for today's visit. On 05/08/2023 at 04:10PM, LPA Dulek received a telephone call from ED Foerschner indicating Resident #1 (R1,) who resides in the Traditions unit, had made an allegation of abuse against Staff #1 (S1.) LPA requested that an incident report and suspected abuse report be sent to the Woodland Hills Regional Office (RO.) Written report was faxed and received on 05/09/2023. Additionally, ED informed LPA that notifications were made to R1's responsible party, primary care physician, the local police department, and Long Term Care Ombudsman (LTCO.) During today's visit, LPA along with Business Office Director toured the facility at 08:51AM, interviewed ED Foerschner at 09:04AM, and LPA obtained copies of pertinent documents. No immediate health and safety hazards were identified during today's visit. Executive Director was informed that Investigator Ryan Miles from CCLD's Investigations Branch will follow up regarding the incident. Exit interview conducted. A copy of today's report was provided.