Facility Evaluation Report
On 11/22/2022 at 10:58AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a case management inspection in regards to incident report received on 11/19/2022. LPA met with Administrator, Janice Gombio.
Incident report dated 11/19/2022 revealed that R1 AWOL without setting off door alarms. Law enforcement contacted facility that R1 was found and R1 returned to the facility a couple hours later.
Interview with staff revealed that R1 left the facility and staff didn't hear the door alarms. R1 might have left the facility near the exit door by R1's room. Staff stated the exit door might have been open at that time.
During record review, LPA observed that physician's report dated 3/17/2021 stated that R1 cannot leave the facility unassisted.
The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalty.
Exit interview conducted. A copy of this report and appeal rights provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction