Complaint Investigation Report

(Continuation from Page 1) On April 11, 2022, R1 fell down on the floor after an attempt to grab on something from the chair. R1 sustained a cut on the forehead. Staff member applied a cold compress. Facility missed to inform the responsible party and resident’s physician. On April 14, 2022 hospice agency assessed the wound and updated the care plan. Based on observation, interviews and file review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Deficiencies observed, Citation was issued per Title 22 Division 6 of the California Code of Regulations.

LPAs Marin and De Perio conducted an exit interview with AD Szalonek LPA discussed the deficiencies citation, and appeal rights with AD. Copy of this report was left in the facility.