Complaint Investigation Report

On 12.23.2024, LPA requested copies of facility documents relevant to the investigation at 2:50 PM. LPA reviewed facility documents interviewed staff and clients between 2:30 AM to 3 PM. LPA interviewed the Administrator, one (1) out of two (2) staff, and one (1) out of four (4) clients, who are in the facility. Interviews revealed that staff left the client at the dining table to grab some milk for the client at 8AM. It was after a few minutes that staff #2 (S2) realized that client #1 (C1) left the facility through the front door of the facility. Facility tried searching within the surroundings for C1 and also called 911. Paramedic found C1 after around 8:30AM at the bottom of the LA river close to Parthenia and Hayvenhust, which is one (1) mile from the facility.

Based on observations, record reviews, and interviews, there is enough information to verify the allegation. Therefore, the allegation is SUBSTANTIATED at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D):

Exit interview conducted and a copy of the report was issued.