Facility Evaluation Report

At 12:25pm, Licensing Program Analyst (LPA) Shira Stamps conducted an unannounced case management visit to this facility in conjunction with complaint control number 31-AS-20220124170445. The purpose of this Case Management visit is to issue a citation for a deficiency observed during the course of the complaint investigation that is not directly related to the complaint allegation.

A review of the facilities medication log for R1 revealed that for the month of January and February the facility did not report to Community Care Licensing the resident’s refusal of medications thirty-two (32) out of thirty-three (33) days the resident refused their medications. During interviews, it was revealed that S1 used emergency intervention techniques for R1 by manually restraining the residents hands. A review of the facility program and plan of operation revealed that the facility did not provide a developed emergency intervention plan to the Department prior to the use of manual restraint.

Exit interview conducted, citation issued, and report and appeals rights delivered.