Facility Evaluation Report

At around 10 am, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct a case management visit. LPA was met by staff Milagros Bumatay and informed the purpose of the visit. Administrator arrived at the facility at around 10:45am .

On 9/15/2023, facility self reported an incident when Resident 1 (R1) with Dementia and is not able to leave the facility unassisted left the facility without staff knowledge. R1 was found by a concerned citizen, was brought to the nearby Fire station. R1 was then sent to Kaiser to get checked. R1 did not sustain any injury per Administrator.

During the visit, S1 states that R1 exited through the side door. And that an alarm has been installed right after the incident. Administrator states R1 was given new medicine.

Type A deficiency is cited per Title 22 California Code of Regulations (refer to Lic 809D).

Exit interview was conducted with Administrator and Appeal Rights was provided.