Facility Evaluation Report

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a case management visit. LPA Moleski met with facility administrator Michelle Swearingen and explained the purpose of the visit.

LPA Moleski opened a complaint investigation at this facility on 4/11/24. During the complaint investigation, it was revealed that a resident (R1) suffered a suspected unwitnessed fall on the morning of 3/30/24, and was sent to the hospital with an injury.

LPA Moleski reviewed CCLD records and observed that no incident reports were received regarding this incident. LPA Moleski asked a staff member (S1) for a fax transmittal sheet from the incident report. S1 informed LPA Moleski that no transmittal sheet was available. S1 provided LPA Moleski with a printout of an incident report on 4/11/24, which described R1's injury and hospital visit. The incident report did not indicate that CCLD or any other agencies were notified of the incident.

This facility is being cited per 22 CCR Section 87211(a)(1)(B). An exit interview was held with Swearingen. Appeal rights and a copy of this report were left with Swearingen.