Facility Evaluation Report

On 8/3/2023 at 12:10pm Licensing Program Analyst (LPA) L. Hall conducted an unannounced Case Management visit regarding an incident report received for Client 1 (C1). LPA met with Administrator, Rolando Gil Mendoza, Administrator, and explained the purpose of the visit.

Incident report sent on 7/14/2023 was for a personal rights incident. Staff 1 (S1) stated that C1 told her responsible party that inappropriate things had happened to her in the facility. The responsible party called the S1 to investigate. The Antioch Police Department was also contacted to investigate. S1 stated the Antioch Police Department spoke with C1 and it was determined that C1 did not have any knowledge about private body parts when asked. LPA reviewed C1's individual support Plan (ISP) dated July 2023 which states C1 has demonstrated poor personal boundaries. S1 made a request to the Regional Center for C1 to have a 1:1 staff due to allegations being made prior to being admitted into the facility.

During LPA's visit S1 was attending a call with C1's day program, case manager, the behavior analyst. The call was regarding C1's termination at the day program as of 9/1/2023.

LPA requested the following documents to be submitted by 8/10/2023: client roster, personnel record (LIC500), physician’s report (LIC602), Individual Program Plan (IPP), Individual Support Plan (ISP), appraisal needs and services plan, police report number, and admission agreement.

Exit interview conducted and a copy of this report provided.