During the visit LPA interviewed residents and staff and reviewed records. LPA reviewed record of one incident where Resident one (R1) and Resident two (R2) engaged in a verbal altercation and R1 grabbed R2 on the right wrist. R2 was observed to have bruising and swelling around the wrist bone. The facility notified Local Law Enforcement, R1 and R2’s responsible party, and physician. R1 admitted fault and that they need to keep their hands to themself. R1 and R2 have a known behaviors of arguing including yelling but this was the first physical altercation observed or reported to the facility. R2 was offered and denied transport to hospital. Facility is to follow up with R2's responsible party to coordinate follow up appointment. LPA observed residents' reappraisals note behaviors including yelling and arguing and staff have offered R1 and R2 septate rooms but they do not want to move into separate rooms. ED stated he would be follow up with physican's for medical assessment at the Departments request and reappraise R1 and R2 to note the observation of changes in behaviors of R1. ED stated he is in the process of scheduling a Family Care Conference in regards to R1's behaviors of yelling and aggression.

Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies observed or cited. Exit interview held, copy of report given.