Facility Evaluation Report

On 9/1/21, at 3:05pm Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management for an incident which occurred on 8/30/21 and received at regional office on 8/31/21. LPA met with facility manager Denica Layne and explained the purpose of the visit. LPA spoke with Licensee William Bonner who gave permission for Denica Layne to sign in his absence. Incident report stated that Resident1 (R1) verbalized to regional center that a staff member grabbed his neck in an aggressive manner.

LPA requested the following documents including: Individualized Program Plan (IPP) R1, care staff notes, incident report, staffing roster, client roster, and physician notes.

LPA conducted interviews with Staff1 (S1) and S2, R1, R2, and R3. LPA reviewed IPP for R1. Facility manager was made aware that additional time is necessary to complete this case management. LPA will contact licensee at a later date for completion. No deficiencies cited as a result of today's visit.

An exit interview was conducted with Denica Layne and a copy of this report was left with Denica.