Facility Evaluation Report

On 6/5/2026 at 1:30 PM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a case management visit. LPA met with Executive Director (ED), Soledad Martinez, and explained the reason for the visit.

LPA received a UIR on May 26, 2026, at approximately 2:00 pm. Memory care resident R1 was taken to an on-site appointment by S2, informing the nurse that R1 had left the appointment office. LPA confirmed with S1 that R1 never left the community. R1 walked outside the office building and was found by a staff member within 15 minutes. S1 stated that an internal investigation had found miscommunication between staff. An in-service training session has been conducted on the importance of monitoring residents and not leaving them unattended in the memory care unit.

An exit interview is conducted, and a copy of the report is provided.