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F0609
D

Failure to Timely Report Resident-to-Resident Abuse Allegation

Petaluma, California Survey Completed on 12-16-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that an abuse allegation involving two residents was reported to the state licensing/certification agency within the required 2-hour timeframe. The incident involved two residents, both with moderately impaired thinking and memory as indicated by their BIMS scores of 10, and diagnoses including schizophrenia, major depressive disorder, and dementia. According to the SOC 341 form, one resident reported being punched in the face by their roommate, after which the resident retaliated by hitting the roommate on the right temple, and the roommate then hit back on the nose. The facility became aware of the incident at 5:10 a.m., but the SOC 341 form was not faxed to the state agency until 8:50 a.m., exceeding the 2-hour reporting requirement. Interviews with facility staff, including the MDS coordinator, Director of Staff Development, and Director of Nursing, confirmed that abuse allegations should be reported to the state within 2 hours of discovery, as outlined in the facility's policy and procedure. The Director of Nursing verified that the facility was aware of the abuse allegation at 5:10 a.m. and acknowledged that the report to the state was made late. The facility's policy defines "immediately" as within 2 hours for allegations involving abuse or resulting in serious bodily injury.

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