Facility Evaluation Report

Licensing Program Analyst (LPA) Nakagawa conducted a case management inspection and met with Ric Pielstick, Administrator. The purpose of the case management was to follow up on three self-reported

CCL received a self reported incident report on 2/12/23 for an incident that occurred on 2/10/23 when

Resident (R1) exhibited aggressive behaviors. Staff were able to intervene and re-direct. CCL received a second self reported incident report on 2/17/23 for an incident that occurred on 2/17/23

when R1 exhibited some agitation and aggressive behaviors when a staff member went in their room.

R1 pushed staff member and closed door. Staff was able to intervene and re-direct. Facility has increased supervision and put other methods in place to help with behaviors.

CCL received a third self-reported incident report on 2/23/23 for an incident on 2/19/23. It was reported that Resident (R2) did not receive regularly scheduled medications. LPA reviewed documentation and it was documented that R2 was not able to take medication at that time; the medication was not unintentionally missed.

No deficiencies cited at todays inspection.