Facility Evaluation Report

On 11/02/22 at 10:30AM Licensing Program Analysts (LPAs) J. Sampair and D. Panlilio arrived unannounced to conduct a case management visit on this date to follow-up on two incident reports that were faxed to CCL on 10/27/22 and 10/31/22. LPAs met with Program Administrator (PA) & Program Director (PD) and explained the purpose of the visit.

Based on record reviews and interviews during today’s visit, client (C1) was first admitted at the facility on 10/12/22. On 10/22/22 at approximately 5PM, staff (S1) observed client’s (C1) unauthorized absence from the facility during a welfare check. C1 did not sign out or notify staff of his departure. On 10/22/22 at approximately 11:59PM, staff filed a report with the local police department (Case# 22-3482). Review of C1's physician's report show C1 can leave the facility unassisted.

PD stated that on 10/28/22 he received a text message from C1’s family member stating that the police notified the other sister that he was deceased. PA also stated that C1’s co-conservator (POA1) informed her that C1 died in a San Francisco jail.

On 10/31/22, the San Mateo coroner’s office confirmed that C1 passed away on 10/27/22.