Facility Evaluation Report

LPA Spaeth arrived at the facility at 11:40. LPA was greeted by Administrator, Wanda Smith. LPA Spaeth stated the purpose of the visit is regarding an incident that occurred at the facility. Licensing Program Analysts (LPA) Melissa Spaeth conducted an unannounced Case- Management - Incident visit. The purpose of this visit is to follow up on a special report submitted to the department on July 7, 2021.

The licensee reported that on 07/07/2021 two residents (R1 and R2) were involved in two inappropriate encounters within the facility. The two encounters both occurred on the same day and was reported to Administrator by caregiver. During this visit LPA reviewed R1's file at 11:45 am.

Based upon LPA's review of the R1's file and under Title 22 General Regulations, the following citations were issued and recorded on LIC 809D.