Facility Evaluation Report

At approximately 3:00PM, Licensing Program Analysts (LPAs) Felias and Loera arrived unannounced to conduct a Case Management - Incident Visit and met with Executive Director, Corrine Bianco, and Health and Wellness Director, Ashley Perrone . The purpose of today's visit is to follow up on self-reported incident that were submitted to Community Care Licensing (CCL).

Incident Report 1/SOC-341: CCL received an incident report and SOC-341 on 07/19/2024. Reports stated that on 07/06/2024, Staff Member 1 (S1) witnessed Staff Member 2 (S2) place their hand over Resident 1's (R1) mouth with soap suds during a shower due to R1 being agitated. S2 was suspended pending internal investigation and sent notice to the facility of their resignation on 07/16/2024. Facility made all appropriate notifications per regulation. Per report, facility will be conducting elder abuse training the week of 07/22/2024 and 07/29/2024.

LPAs requested documentation. Facility to submit proof of elder abuse training once completed.

Exit interview conducted. Copy of report and LIC811 (Confidential Names) discussed and provided to Executive Director/Administrator, and Health and Wellness Director. Signature on form confirms receipt of documents.