Facility Evaluation Report

Licensing Program Analyst (LPA) Nune Margaryan conducted a Case Management – Incident visit in response to a self-reported Special Incident Report (SIR) and SOC 341 received by the Department on 07/20/2026 regarding an incident involving alleged misconduct by Staff 1 (S1) toward Client 1 (C1).

The Incident Report indicated that on 07/19/2026, while S1 was administering medication, C1 poured a cup of matcha on S1. In response, S1 poured water on C1. The incident was reported to the facility Administrator on 07/20/2026. Upon notification, the Administrator immediately interviewed S1, who admitted to pouring water on C1 in response to C1's actions. S1 was removed from duty on 07/20/2026 and placed on administrative leave. The facility's management team conducted an internal review and determined that S1 will be terminated. The Administrator provided LPA with a copy of the Coaching and Corrective Action (CCA) form documenting the disciplinary action and planned termination. The facility also completed a review of its Zero Tolerance and Mandated Reporter/Abuse Policy with staff on 07/29/2026.

During today's visit, LPA toured the facility and interviewed the Administrator and C1. LPA observed no immediate health and safety concerns at the facility.

An exit interview was conducted, and a copy of this report was provided to Administrator.