200152001133Fall InvestigationAAAA12806425525525500000000000000001105251020001Arial14005010184215040000000002001520011330000000000000000000000000000000000000000000000002001520011330001000000000000000000000000000000000000000000000000001000000000000000002001520011330000000000000000000000000000000000000000000200152001136^ View Fall DocumentationAAAB22422417500000000000000000001105251021000Arial800000184215040000000002001520011360000000000000000000000000000000000000000000000002001520011360001000000000000000000000000000000000000000000000000901000000000000000002001520011360000000000000000000000000000000000000000000200152001136145541000020100002001520011193^ Incident InvestigationAAAC22422417500000000001000000001105251021000Arial800000184215040000000002001520011193000000000000000000000000000000000000000000000000200152001119300010000000000000000010000000000000000000000000000009010000000000000000020015200111930000000000000000000000000000000000000000000200152001119312001520011194-1001020015200112Fall DataABAA1281286425525525500000000000000001105251020001Arial140050101842150400000000020015200112000000000000000000000000000000000000000000000000200152001120001000000000000000000000000000000000000000000000000001000000000000000002001520011200000000000000000000000000000000000000000002001520011101DID FALL RESULT IN INJURY?ABAB21220820000010100010000000001105251020000Arial8000001842150400000000020015200111010000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111010000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111010000000010000000000000000000000000000000000000002001520011101000001000000001001000000110000000000000000000000000000100000000000000000200152001110100000000000000000000000000000000000000000002001520011101120015200111022001520011101220015200111072001520011101320015200111032001520011101120015200111022001520011101220015200111072001520011101320015200111032001520011102yes - presumed minor 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injury = skin tears,ACAB25525525500000000000000000001105251020000Arial8000101797457400000000020015200111100000000000000000000000000000000000000000000000020015200111100010000000000000000000000000000000000000000000000000010000000000000000020015200111100000000000000000000000000000000000000000002001520011114abrasions, lacerations,ACAC25525525500000000000000000001105251020000Arial8000101797457400000000020015200111140000000000000000000000000000000000000000000000002001520011114000100000000000000000000000000000000000000000000000000100000000000000000200152001111400000000000000000000000000000000000000000002001520011115sprains, hematomas,ACAD25525525500000000000000000001105251020000Arial8000101797457400000000020015200111150000000000000000000000000000000000000000000000002001520011115000100000000000000000000000000000000000000000000000000100000000000000000200152001111500000000000000000000000000000000000000000002001520011116superficial bruises, or anyACAE25525525500000000000000000001105251020000Arial8000101797457400000000020015200111160000000000000000000000000000000000000000000000002001520011116000100000000000000000000000000000000000000000000000000100000000000000000200152001111600000000000000000000000000000000000000000002001520011117fall related injury that causeACAF25525525500000000000000000001105251020000Arial8000101797457400000000020015200111170000000000000000000000000000000000000000000000002001520011117000100000000000000000000000000000000000000000000000000100000000000000000200152001111700000000000000000000000000000000000000000002001520011118resident to complain of pain.ACAG25525525500000000000000000001105251020000Arial8000101797457400000000020015200111180000000000000000000000000000000000000000000000002001520011118000100000000000000000000000000000000000000000000000000100000000000000000200152001111800000000000000000000000000000000000000000002001520011119Major Injury = bone 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OBSERVED?ADAB21220820000010100000000000001105251020000Arial800000184215040000000002001520011380000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200113800000000000000000000000000000002000000000000011011100000000000000000000000000000000200152001138000000001000000000000000000000000000000000000000200152001138000001000000000000000000000000000000000000000000000000100000000000000000200152001138000000000000000000000000000000000000000000020015200111yesADAC025525500000100100000000001105251020000Arial800000179745740000000002001520011100000000100000000000000000000000000000000000000020015200111014//5MAGkAcwB0ACAAbgBhAG0AZQBzADoAIAA=00000000000000000000100000000000000000000000000000010000000000000000020015200111000000000000000000000000000000000000000000020015200111120015200113832001520011112001520011383200152001139noADAD025525500000100100000000001105251020000Arial8000001797457400000000020015200113900000000100000000000000000000000000000000000000020015200113900000000000000000000000100000000000000000000000000000010000000000000000020015200113900000000000000000000000000000000000000000002001520011391200152001138320015200113912001520011383200152001141WAS RESIDENT ALONE?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 CAREGIVER:AEAB21220820000010100000000000001105251020000Arial8000001842150400000000020015200111240000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111240000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111240000000010000000000000000000000000000000000000002001520011124014//5BAHMAcwBpAGcAbgBlAGQAIABDAGEAcgBlAGcAaQB2AGUAcgAgAGYAbwByACAAcgBlAHMAaQBk AGUAbgB0ADoA00100000000000000000000000000000000000000000000000010000020015200114000000000020015200111240000000000000000000000000000000000000000000200152001140LOCATION OF FALL:AEAD21220820000010100000000000001105251020000Arial800000184215040000000002001520011400000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200114000000000000000000000000000000002000000000000011011100000000000000000000000000000000200152001140000000001000000000000000000000000000000000000000200152001140014//5EAGUAcwBjAHIAaQBiAGUAIABhAHMAIABlAHgAYQBjAHQAbAB5ACAAYQBzACAAcABvAHMAcwBp AGIAbABlADoAIAA=0010000000000000000000000000000000000000000000000001000000000000000002001520011400000000000000000000000000000000000000000000200152001144REASON FOR LOCATION:UkVBU09OIFJFU0lERU5UIFdBUyBJTiBUSEFUIExPQ0FUSU9OOiA=AEAF21220820000010100000000000001105251020000Arial800000184215040000000002001520011440000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200114400000000000000000000000000000002000000000000011011100000000000000000000000000000000200152001144000000001000000000000000000000000000000000000000200152001144014//5FAG4AdABlAHIAIAByAGUAYQBzAG8AbgAgAGYAbwByACAAcgBlAHMAaQBkAGUAbgB0ACcAcwAg AGwAbwBjAGEAdABpAG8AbgA6AA==001000000000000000000000000000000000000000000000000100000000000000000200152001144000000000000000000000000000000000000000000020015200114AFAA1281286425525525500000000000000001105251020001Arial140050101842150400000000020015200114000000000000000000000000000000000000000000000000200152001140001000000000000000000000000000000000000000000000000001000000000000000002001520011400000000000000000000000000000000000000000002001520011184^ View Past Fall 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# FALLS PAST 3 MONTHS: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 other fallsAFAD025525500000100100000000001105251020000Arial80000017974574000000000200152001116000000000000000000000000000000000000000000000000200152001116000000000000001000000001010000000000000000000000000000100000000000000000200152001116000000000000000000000000000000000000000000020015200111612001520011463200152001116120015200114632001520011169had other falls:AFAE025525500000100100000000001105251020000Arial8000001797457400000000020015200111690000000000000000000000000000000000000000000000002001520011169014//5OAHUAbQBiAGUAcgAgAG8AZgAgAGYAYQBsAGwAcwA6AA==000000000001000000001010000000000000000000000000000100000000000000000200152001116900000000000000000000000000000000000000000002001520011169120015200114632001520011169120015200114632001520011175unable to determineAFAF025525500000100100000000001105251020000Arial800000179745740000000002001520011175000000000000000000000000000000000000000000000000200152001117500000000000000100000000101000000000000000000000000000010000000000000000020015200111750000000000000000000000000000000000000000000200152001117512001520011463200152001117512001520011463200152001147PROTECTIVE/SAFETY DEVICES:V0VSRSBQUk9URUNUSVZFL1NBRkVUWSBERVZJQ0VTIElOIFVTRSBBVCBUSU1FIE9GIEZBTEw/ICA=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unitAGAC02552550000010010000000000000000Arial800000179745740000000002001520011178000000000000000000000000000000000000000000000000200152001117800000000000000100000000101000000000000000000000000000010000000000000000020015200111780000000000000000000000000000000000000000000200152001117812001520011177320015200111781200152001117732001520011179B unitAGAD02552550000010010000000000000000Arial800000179745740000000002001520011179000000000000000000000000000000000000000000000000200152001117900000000000000100000000101000000000000000000000000000010000000000000000020015200111790000000000000000000000000000000000000000000200152001117912001520011177320015200111791200152001117732001520011180C 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resident the followingAIAB25525525500000000000000000001105251020010Arial8000101797457400000000020015200111260000000000000000000000000000000000000000000000002001520011126000100000000000000000000000000000000000000000000000000100000000000000000200152001112600000000000000000000000000000000000000000002001520011127immediately after the fall:AIAC25525525500000000000000000001105251020010Arial8000101797457400000000020015200111270000000000000000000000000000000000000000000000002001520011127000100000000000000000000000000000000000000000000000000100000000000000000200152001112700000000000000000000000000000000000000000002001520011128WHY DO YOU THINK YOU FELL?AIAD21220820000010100000000000001105251020000Arial8000001842150400000000020015200111280000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111280000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111280000000000000000000000000000000000000000000000002001520011128014//5SAGUAYwBvAHIAZAAgAHIAZQBzAHAAbwBuAHMAZQAgAGkAbgAgAHIAZQBzAGkAZABlAG4AdAAn AHMAIABvAHcAbgAgAHcAbwByAGQAcwA6AA==001000000000000000000000000000000000000000000000000100000000000000000200152001112800000000000000000000000000000000000000000002001520011129WERE YOU HUNGRY?AIAE21220820000010100000000000001105251020000Arial8000001842150400000000020015200111290000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111290000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111290000000000000000000000000000000000000000000000002001520011129000001000000000000000000000000000000000000000000000000100000000000000000200152001112900000000000000000000000000000000000000000002001520011130WERE YOU IN PAIN?AIAF21220820000010100000000000001105251020000Arial8000001842150400000000020015200111300000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111300000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111300000000000000000000000000000000000000000000000002001520011130000001000000000000000000000000000000000000000000000000100000000000000000200152001113000000000000000000000000000000000000000000002001520011131WERE YOU BORED?AIAG21220820000010100000000000001105251020000Arial8000001842150400000000020015200111310000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111310000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200111310000000000000000000000000000000000000000000000002001520011131000001000000000000000000000000000000000000000000000000100000000000000000200152001113100000000000000000000000000000000000000000002001520011132DID YOU NEED 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RESIDENT COMMENTS:AIAK21220820000010100000000000001105251020000Arial80000018421504000000000200152001113500000000000000000000000000000002000000000000011011100000000000000000000000000000000200152001113500000000000000000000000000000002000000000000011011100000000000000000000000000000000200152001113500000000000000000000000000000000000000000000000020015200111350000010000000000000000000000000000000000000000000000001000000000000000002001520011135000000000000000000000000000000000000000000020015200116SurroundingsAKAA1281286425525525500000000000000001105251020001Arial14005010184215040000000002001520011600000000000000000000000000000000000000000000000020015200116000100000000000000000000000000000000000000000000000000100000000000000000200152001160000000000000000000000000000000000000000000200152001148ENVIRONMENTAL CLUES:AKAB21220820000010100000000000001105251020000Arial8000001842150400000000020015200114800000000000000000000000000000002000000000000011011100000000000000000000000000000000200152001148000000000000000000000000000000020000000000000110111000000000000000000000000000000002001520011480000000010000000000000000000000000000000000000002001520011480000010000000000000000000000000000000000000000000000001000000000000000002001520011480000000000000000000000000000000000000000000200152001145water spills,AKAC025525500000100100000000001105251020000Arial8000001797457400000000020015200114500000000100000000000000000000000000000000000000020015200114500000000000000000000000100000000000000000000000000000010000000000000000020015200114500000000000000000000000000000000000000000002001520011451200152001148320015200114512001520011483200152001150clutter on 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WEEK: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 OF FACTORS:AWAB21220820000010100010000000001105251020000Arial800000184215040000000002001520011810000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200118100000000000000000000000000000002000000000000011011100000000000000000000000000000000200152001181000000001000000000000000000000000000000000000000200152001181000001000000000000000000100000000000000000000000000000100000000000000000200152001181000000000000000000000000000000000000000000020015200118112001520011672001520011812200152001182200152001181320015200111722001520011814200152001117320015200118152001520011167200152001181620015200111682001520011811200152001167200152001181220015200118220015200118132001520011172200152001181420015200111732001520011815200152001116720015200118162001520011168200152001167environmental factors 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between falls:aWYgbW9yZSB0aGFuIG9uZSBmYWxsLCBub3RlIHNpbWlsYXJpdGllcyBiZXR3ZWVuIGZhbGxzICh0 aW1lLCBwbGFjZSwgcmVzaWRlbnQgYWN0aXZpdHkpOiA=AXAC025525500000100100000000001105251020000Arial80000017974574000000000200152001183000000001000000000000000000000000000000000000000200152001183014//5MAGkAcwB0ACAAcwBpAG0AaQBsAGEAcgBpAHQAaQBlAHMAIABuAG8AdABlAGQAOgAgAA==0000000000000000000010000000000000000000000000000001000000000000000002001520011830000000000000000000000000000000000000000000200152001183120015200111713200152001183120015200111713200152001184relationship between clues:cmVsYXRpb25zaGlwIG5vdGVkIGJldHdlZW4gZW52aXJvbm1lbnRhbCBhbmQgaGVhbHRoIGNhcmUg 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DONE:DMAB02552550001010000000000000110525102000000000018421504000000000200152001130300000000000000000000000000000002000000000000011011100000000000000000000000000000000200152001130300000000000000000000000000000002000000000000011011100000000000000000000000000000000200152001130300000000000000000000000000000000000000000000000020015200113030010010000000010000000000100000000000000000000000000000000000000000000002001520011304DNAA128128642552552550000000000000000000001Arial140050101842150400000000020015200113040000000000000000000000000000000000000000000000002001520011304000100000000000000000000000000000000000000000000000000100000000000000000200152001130400000000000000000000000000000000000000000002001520011305DATE OF INCIDENT:DNAB21220820000010100000000000001105251020000Arial8000001842150400000000020015200113050000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200113050000000000000000000000000000000200000000000001101110000000000000000000000000000000020015200113050000000000000000000000000000000000000000000000002001520011305012//5TAGUAbABlAGMAdAAgAEQAYQB0AGUAIABvAGYAIABJAG4AYwBpAGQAZQBuAHQALgA=001000000001000000000010000000000000000000000000000100000000000000000200152001130500000000000000000000000000000000000000000002001520011306DOAA128128642552552550000000000000000000001Arial140050101842150400000000020015200113060000000000000000000000000000000000000000000000002001520011306000100000000000000000000000000000000000000000000000000100000000000000000200152001130600000000000000000000000000000000000000000002001520011307^ View ReportDOAB22422117500010000000000000001105251021000Arial8000001000000000020015200113070000000000000000000000000000000000000000000000002001520011307000100000000000000000000000000000000000000000000000065537010000000000000000020015200113070000000000000000000000000000000000000000000200152001130726741100000200000020015200113071202001520011308^ Back to Fall InvestigationDOAC22422117500000000001000000001105251021000Arial80000018421504000000000200152001130800000000000000000000000000000000000000000000000020015200113080001000000000000000001000000000000000000000000000000901000000000000000002001520011308000000000000000000000000000000000000000000020015200113081200152001133-100102001520011309SignDPAA20215117900000000000000000001105251021001Arial140050101842150400000000020015200113090000000000000000000000000000000000000000000000002001520011309000100000000000000000000000000000000000000000000000065536010000000000000000020015200113090000000000000000000000000000000000000000000200152001130915020015200113090000000000000000000000000000000000000000000-1000000000000002001520011Fall/Incident 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20015Quality Assurance20013416501Arial10100

1455Incidents (Pick Dates)1AP///9BI33fQgGoAAPz9fzQAAADugAB2PcS3ksDpEgAAAAAAzAkaAAEAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAEAAAAAAAAAAAAAAAEAAAAAAAAAAgAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAABAAAAAQAAAAEAAAAAAAAAAAAAAAAAAAABAAAAAAAAAAAAAAABAAAAAQAA AAAAAAAAAAAAAQAAAA==0000000000013550AQAAAAAAAAAAABARAAAAAAAAAADIt6gAAAAAAAEAAAAAAAAAAAAAAGjmEgBDE6oAK7wAAGjmEgCQ AR4ENL0AAJQQAQvMCRoAHg4QIVTlEgBy/e13zAkaADS9AACUEAELzAkaADS9AADNq7rcAAAAAKTl EgA0vQAAzOUSAIDlEgAgm/J3kAEeBMzlEgCh/u13Yf7tdyAxqpIAAAAAzAkaANToEgAkAAAAAQAA AAAAAAAAAAAAcAAAAP//////////IAAAABzmEgD4+/1/AAAAAPjlEgAmft93APz9fzQAAAAE5hIA 5BD8AVd+33foTH12wOkSAPj7/X8AAAAAAAAAAAAAAADI5RIAlBABC0TmEgD6mdl3gOexAQ==00359Fall Documentation1AACUAqIAkwKTAJQAIIoBdq8ErgWSCgAAAABoim8vrgDmm8deK1sxWwEAAAAAAAAAAAAAAAAAAAAA AAAAAQAAAAEAAAAAAAAAAAAAAAAAAAAAAAAAAQAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAABAAAAAQAAAAEAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA 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Label105368709111Arial-2147483640091000.1979999989271161.751.197999954223630.71899998188018800000000000000000000000000000000000000000000000000000000QWRtaXQgRGF0ZTo=0000000000000Arial00101167772150000000000000000002550000000000000002674159429Report Label305368709110Arial-21474836400102000.1979999989271162.562000036239621.177000045776370.750010000000010000000000000000001001001000000000101000000000000000000000MS Sans Serif-214748364001011677721500000000000000028626124801170000000000000002674159430105368709111Arial-2147483640091000.1979999989271165.811999797821041.197999954223630.79199999570846600000000000000000000000000000000000000000000000000000000Q29kZSBTdGF0dXM60000000000000Arial-21474836400101167772150000000000000000002550000000000000002674159431Code Status305368709110Arial 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Dates)11013550111355011110001355011120008200190-1-1-1-101355011220030200410-1-1-1-101355011320056200180-1-1-1-101355011420056200470-1-1-1-10013514Fall Documentation11013514111351411110001351411120056200170-1-1-1-101351411220056200460-1-1-1-1001351411320008200191-1-1-1-10J1900B0102001520011102920J19000102001520011103920J19000202001520011102920J19000302001520011107920J1900C0102001520011107920J1900A0102001520011103920