Table
	Date Date From To	Report number Report number	Allegation Allegation Failed to administer medication as ordered Failed to assist with toileting Failed to assure resident rights Failed to follow care plan Failed to keep medication record current or accurate Failed to perform adequate screening or assessment Failed to properly plan care Failed to provide a safe medication administration system Failed to provide appropriate staffing Failed to provide inservice Failed to provide safe environment Failed to provide service Failed to report potential or suspected abuse Failed to submit timely or adequate staffing documentation Failed to use an ABST	Level Level Between And	Type Type Abuse: Neglect Licensing Violation	Actions
	6/28/2019	00039729-AP-027959	Failed to provide service	3	Abuse: Neglect
	5/1/2019	SR20013	Failed to report potential or suspected abuse	3	Licensing Violation
	6/5/2018	SR18168	Failed to report potential or suspected abuse	3	Licensing Violation
	5/2/2022	CALMS - 00028202	Failed to submit timely or adequate staffing documentation	2	Licensing Violation
	11/1/2022	CALMS - 00034359	Failed to submit timely or adequate staffing documentation	2	Licensing Violation
	10/1/2022	CALMS - 00033114	Failed to submit timely or adequate staffing documentation	2	Licensing Violation
	9/1/2022	CALMS - 00031934	Failed to submit timely or adequate staffing documentation	2	Licensing Violation
	7/1/2022	CALMS - 00029836	Failed to submit timely or adequate staffing documentation	2	Licensing Violation
	5/1/2023	CALMS - 00043065	Failed to submit timely or adequate staffing documentation	2	Licensing Violation
	1/12/2024	OR0004781900	Failed to use an ABST	2	Licensing Violation

40 records found | Page 4 of 4