Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced visit on 4/18/24, stemming from previous case management visit on 3/15/24.

It was revealed that Client#1 (C1) was taken to the hospital in 4/6/2024 via 911 due to C1 injuring themselves and causing property damage. As of 4/18/24, C1 has not retuned to the facility and remains in the hospital. This licensing agency did not receive a written report within 7 days from date of occurrence of 4/6/24. LPA Ramirez will issue deficiency based on record review and staff interviews. This facility was previous cited on 3/15/24 for noncompliance of Title 22- 80061(b)(1)(E)-Reporting Requirements. Therefore, LPA Ramirez will issue an immediate civil penalty in the amount of $250.

(b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in (2) below shall be submitted to the licensing agency within seven days following the occurrence of such event. (1) Events reported shall include the following: Any unusual incident or client absence which threatens the physical or emotional health or safety of any client. 1. For community care facilities that serve children, a pregnancy or termination of a pregnancy does not, in and of itself, constitute an unusual incident unless it meets the criteria specified for mandated reporting in Penal Code section 11166 (a).

This requirement was not met as evidenced by: Licensee failed to report to this licensing agency that C1 was taken to the hospital due to self injury and property damage.

Deficiency was observed and an immediate civil penalty in the amount of $250 was assessed. A copy of this report, LIC 421 and appeals rights was provided.