1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 | Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced Case Management - Incident visit. LPA identified herself and was granted entry into the facility by Aileen Spence Associate Executive Director, with whom LPA met and discussed the purpose of the visit.
Today's visit was initiated in response to an SOC341 Report of Suspected Dependent Adult/Elder Abuse, which was received by Community Care Licensing (CCL) on March 4, 2025, in which licensee self reported a resident to resident altercation. The report said that on March 2, 2025 at approximately 12:10 PM Resident 1 (R1) and Resident 2 (R2) each struck one another. Staff 1 (S1) stated that R1 struck R2 after R2 struck R1. R2 did not have injuries. R1 did have a swollen wrist. Both R1 and R2 were unable to recall the incident. Records reviewed showed that all the appropriate responsible parties and Medical Doctors were made aware of the incident. R1 was taken to the hospital and returned with no injuries.
During today’s visit, LPA briefly toured the facility and performed a welfare check, verifying that R1 and R2 were unharmed/uninjured. LPA also collected copies of pertinent facility records, and interviewed relevant staff.
No deficiencies were observed or cited on this date. An exit interview was conducted, and a copy of this report and Licensee Rights LIC 9058 (03/22) were left with Associate Executive Director Aileen Spence, whose signature on this form confirms receipt of these documents.
|