Complaint Investigation Report

Interviews with staff revealed the following, C1 has been observed with behavior of compulsive eating disorder recently. Staff have observed C1 wanting to eat non-eating items around C1's environment. Staff have prevented C1 from eating items when observed. However, on 3/9/24 C1 was observed vomiting what seemed to be aluminum foil. C1 may have ingested aluminum foil during the night shift. C1 may have accessed the aluminum foil from the trash and ingested it. Per staff there was no awake staff on duty prior to this incident during the night shift. It was reported to C1’s responsible party who took C1 to the doctor. Documents reviewed revealed, Last IPP dated 9/11/2019 does not note a history of compulsive eating disorder. Facility’s Progress Report dated 1/1/24 notes C1 has behaviors of consuming foreign bodies and staff are using redirection to prevent behavior. Hospital discharge documents for visit on 3/10/24 revealed C1 had evidence of ingesting foreign bodies. Facility has placed a one-on-one staff during the night shift to assist C1 to prevent further incidents of ingesting foreign bodies. Lanterman Regional Center's Service Coordinator is aware of the behaviors and is currently collaborating with facility staff and regional center's team to provide services for C1.

Based on LPAs observations and interviews which were conducted record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 6 and Chapter 1 are being cited on the attached LIC 9099D.

Exit interview was conducted with Segundino Gotladera and a copy of this report, LIC 9099D, and appeal rights were provided.