Facility Evaluation Report, 09/15/2023 — Gerrylaide Manor, Hayward CA

Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct a case management in response to Special Incident Reports (SIRs) for resident (R1) submitted by the facility. LPA met with staff, Magdalena Budol. LPA called and spoke with Aidan Castrence, administrator, over the phone, and informed the reason for visit. Administrator can not come to the facility, and authorized Dionisio Opulento, staff, to sign and receive this report. Opulento arrived after several minutes.

1. SIR dated 9/04/23 with incident date 9/02/23 - On Saturday, 9/02/23, R1 was seen in his room sleeping at 2:00 pm and 4:00 pm. Staff noticed the gate was open where someone either entered or exited the facility. They checked, and R1 was not in the facility. Staff went out and checked outside the facility, and 9-1-1 was called. Dispatch stated that R1 was picked-up, and they (staff) can pick R1 up at San Leandro hospital. R1 was unharmed and brought back to the facility.

2. SIR dated 9/04/23 with incident dated 9/03/23 - On Sunday afternoon, R1 was seen in his room awake at 1:30 pm. At around 2:00 pm, staff went to the kitchen to call another staff to watch R1. As these staff were walking back to the house (building) where R1 was, they noticed from 20 yards away someone just left the facility. Staff checked and found R1 not in his room. Staff searched and called 9-1-1. A sheriff deputy came to the facility and took statements, and told the administrator that R1 tried to force himself in a public bus. R1 was picked-up by the staff from John George.

LPA conducted inspection. LPA inspected the building were R1's room was at, and observed the front gate. LPA reviewed R1's file, and obtained copies of the following: Regional Center of East Bay (RCEB) Placement Information; LIC601 Identification and Emergency Contact Information; LIC602 Physician's Report; LIC625 Appraisal/Needs and Services Plan; Individual Program Plan (IPP); Notification of Individual High Risk Behavior and Dangerous Propensities; Hospital After Visit Summary