Facility Evaluation Report

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced case management visit at this facility to issue a deficiency discovered during the course of the investigation on complaint control no.: 31-AS-20230727160520 wherein during Investigator Zertuche's interview, three (3) staff stated that staff #1 (S1) was sleeping on the sofa at the living room. LPA's record review during the initial visit on 07/28/23 also revealed that the facility did not report the incident occurred on 07/23/23 wherein Resident #1 (R1)'s arm was caught in own bed rail resulting hospitalization and fracture on R1's clavicle.

Citation issued. Appeal rights discussed and given. Exit interview conducted. Copy of this report issued.