Complaint Investigation Report

197609870-9-29-2021-31-AS-EMIR-C8MUJA-20211110143712

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 21731 VENTURA BLVD., STE. 250

This is an official report of an unannounced visit/investigation of a complaint received in our office on

09/27/2021 and conducted by Evaluator Alexander Pitz

COMPLAINT CONTROL NUMBER: 31-AS-20210927120203

Staff did not prevent a client from wandering while in care

Licensing Program Analyst (LPA) Pitz conducted an unannounced visit on this day in response to the above allegation.

As part of this investigation, LPA interviewed the co-complainant on 9/28/21 telephonically; interviewed the complainant on 9/29/21; interviewed the administrator on 9/29/21 at the facility; reviewed client 1's (C1's file) on 9/29/21.

Allegation #1, that "staff did not prevent a client from wandering while in care," has been substantiated based on the interviews conducted and records reviewed. A review of C1's Individual Program Plan (IPP) indicates that C1 requires supervision when outside of the facility, and has a history of elopement. The administrator confirmed on 9/29/21 that C1 eloped from the faciltiy on 9/26/21 at approximately 3:00 a.m., and was eventually brought back to the faciilty by a neighbor. LPA confirmed that this is the third instance of C1 eloping from the faciltiy within the last year.

Report reviewed, signed and deliverd. Exit interview conducted, deficiency cited on 9099D page.