Laura lives in a community home. She is 28 years old, has multiple disabilities, is hearing impaired and unable to speak; however, those familiar with her can communicate using sign language. She engages in SIB (self-injurious behavior) almost constantly, and when she does can also become quite aggressive toward other individuals in the home. As a consequence, the provider frequently assigns 1:1 staff with the requirement that she must never be out of the staff member’s sight.
On October 1 at about 9:30 p.m., the administrator on duty received the following incident report which was written by Karen, the person who had been assigned 1:1 with Laura that day beginning at 4:00 p.m.
At about 8:30 this evening I was helping Laura get ready for bed. I noticed that her left eye was black. It looked as if somebody had hit her. I didn’t notice it earlier in the evening.