Facility Evaluation Report

Licensing Program Analyst (LPA) Delmundo arrived to facility unannounced to conduct a case management inspection to follow-up on a self reported incident involving resident (R1). Report indicated that on February 17, 2024, at around 5:30 p.m., staff was done preparing dinner and R1 was about to wake up from supposed nap, staff found R1 missing. R1 exited from his room through the window with screen. The alarm was removed. Staff searched the nearby establishments, stores and bus stations immediately but unsuccessful. Staff called the Sheriff Department.

On this day, March 1, 2024, LPA met with Eric Umali, administrator, and informed the reason for visit.

LPA toured the facility with the administrator. LPA inspected the exit doors and windows which were observed with alarm/auditory signals. LPA conducted interviews. Review of documents revealed R1 has AWOL behavior, will walk away from the home and community and requires line of sight supervision. LIC602 Physician’s Report indicated R1 cannot leave the facility unassisted.

Administrator stated R1 was found by the police on February 24, 2024 drinking coffee at Starbucks in Daly City, and was brought back to the facility that day.

Deficiency is cited from Title 22 California Code of Regulations, and listed on 809D. Failure to submit proof of correction along with the LIC9098 Proof of Correction form, and any repeat violations within 12 month period may result in civil penalties.

Deficiency and plan and proof of correction were discussed with the administrator.

Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form, and copy of this report provided,