Facility Evaluation Report

On 10/19/2022 at approximately 2:45 pm, Licensing Program Analyst (LPA) Renee Campbell arrived unannounced to conduct a case management visit regarding an incident report submitted on 09/29/22. LPA met with Supportive Living Instructor (SLI) Meleani Wheeler and explained the purpose of the visit. After contacting the Director, for permission to assist and sign licensing documents, SIL provided the necessary documents regarding the incident.

Though an incident report was submitted, it was not reported that R1's brother was contacted. LPA suggested SLI call brother to confirm he knew about it. LPA observed that the brother was listed as R1's emergency contact with his phone number. LPA saw SLI make call on speaker phone and LPA spoke to the brother. He confirmed he was notified of R1's accident.

LPA interviewed Staff (S1) regarding the incident that occurred on 09/29/22 at 6:20 am. S1 explained he heard a scream and came in to find R1 on the floor naked at the foot of her bed.Staff (S2) came in and called 911.

S1 stated that R1 has no significant history of falling, while living at the facility but she could be unsteady on her feet. R1 uses a walker and is monitored during showers, without hands-on support. She can dress herself and get to the bus with little assistance. LPA conducted additional interviews with residents who were present in the facility at the time of the incident.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit. An exit interview was held, and a copy of the report was left with Supportive Living Instructor, Meleanie Wheeler.