Facility Evaluation Report

At approximately 9:25AM, Licensing Program Analysts (LPAs) Deniz and Felias arrived unannounced to conduct a Case Management - Incident Visit and met with Administrator, Camille Brown. The purpose of the visit was to follow up on an incident report/SOC341 that was self-submitted to Community Care Licensing (CCL).

Incident Report 1/SOC341: CCL received an incident report and SOC341 on 04/18/2025. Reports stated that on 04/15/2025, facility management became aware of an incident that occurred on the evening of 04/14/2025. Per reports, Staff Member 1 (S1) witnessed Staff Member 2 (S2) make open-hand contact with Resident 1's (R1's) cheek. Facility made all notifications per Title 22 Regulations. Reports stated that S2 was currently suspended pending internal investigation.

During visit, LPAs were informed that S2 is no longer employed at the facility. LPAs obtained additional documentation related to the incident.

Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.