Facility Evaluation Report

MH Facility LLC, Antioch09/09/2025Licence 079201342

Capacity4
Census0
Date signed09/09/2025 03:37:08 PM
Name of licensing program analystLaura Hall
Name of licensing program managerHarpreet Humpal
The inspector’s account

On 9/9/2025 at 2:05pm, Licensing Program Analyst (LPA) L. Hall conducted an unannounced Case Management visit regarding an incident that was reported to CCLD on 9/5/2025, 9/6/2025, and 9/8/2025. LPA met with Monique Gran, Administrator, and explained the purpose of the visit.

The first incident occurred on 9/4/2025, where C1 AWOL'd. C1 was admitted to facility on 10/7/2024. S1 stated on the day of the incident C1 left the facility on his bicycle, went to Wal-Mart, and did not return to the facility. On 9/5/2025, S1 received call that C1 was found in Nevada City. S1 drove and picked C1 up. On 9/7/2025, C1 AWOL'd again, was taking into custody, and is still in custody. LPA reviewed Individual Program Plan (IPP) addendum and the physician's report both indicated that C1 is able to go into the community without assistance. LPA requested a copy of C1's IPP addendum.

Exit interview conducted and this report was provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction