Facility Evaluation Report

On 04/13/2022, Licensing Program Analysts (LPAs)T. White and R. Campbell, conducted an unannounced case management visit regarding an incident report which occurred on 03/03/2022. LPAs met with Supervisor, Susan Lo and explained the purpose of the visit.

LPA White reviewed the incident report submitted to CCLD on 03/12/2022. Based on incident report, Client #1 (C1) walked into the dining room, grabbed the stand-up dust pan, throwing it at Client #2 (C2). The handle of the dustpan struck C2 in the right eye, causing redness and inflammation. Staff #1 (S1) directed all other residents away from the area and contacted 911. C2 was assessed and provided ice pack until EMS arrived.

Based on documentation, C1 was given a 30- day eviction on March 29, 2022 regarding C1's violation to house rules. Based on interview with S1, C1 was transferred to another (sister) Everwell facility in Fresno due to additional behavioral support staff being provided. C1's conservator is currently looking for placement. LPA informed S1 to contact CCLD once C1 has been placed at new facility.

Exit interview conducted with Supervisor and a copy of report given.