Facility Evaluation Report

At approximately 1:00PM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct a case management visit in regards to an incident that occurred on 09/08/2024. LPA met with Direct Support Personnel (DSP) Kaye Hahner and reviewed records. Based on a review of records, Client, C1, is supposed to have staff nearby while at the facility and with then at all times in the community for their safety. On 09/08/2024, C1 returned from an outing with staff and left again soon after, without staff knowledge. C1 returned approximately 15 minutes later.

LPA reviewed records and observed C1's Individual Service Plan (ISP) was last updated 03/2024 and their Individual Program Plan, (IPP) was last updated 06/20/2024. The IPP notes C1 is to have staff nearby while at home and at all times in the community. The ISP does not mention this observation note and has not been updated to reflect this new behavior. C1's physician report was faxed from the doctors office and is missing page two, which notes whether C1 is able to leave the facility unassisted.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Kaye Kahner and Appeal rights were given.