Facility Evaluation Report

On 05/28/2024 LPA Casillas arrived at facility above to conduct an initial 10-day complaint investigation for complaint #31-AS-20240523125725. This Case Management is not related to the original complaint visit. During the complaint investigation LPA observed that facility did not report an incident that occurred on 05/15/24. LPA Casillas met with House Manager, Vashan Bobney. Administrator was called and assigned House Manager to sign this report, as he could not meet LPA.

During records review LPA noticed that there was no incident report submitted to Community Care Licensing (CCL) for an incident that occurred on 05/15/24. LPA interviewed House Manager and it was discovered that an incident report was not made to Community Care Licensing (CCL). House manager was not able to produce confirmation for reporting the incident.

LPA Casillas explained to House Manager the need and importance to report any and all incidents to CCL in a timely manner. LPA explained to House Manager that vendorized training would have to be submitted to LPA by 06/04/24 via email.

Citation Issued. Appeal rights discussed and provided. Exit Interview conducted.