Facility Evaluation Report

On 10/27/23 at 8:15am, Licensing Program Analyst (LPA) Regina Cloyd made an unannounced case management visit to obtain additional information regarding an a client-on-client incident reported on a suspected dependent adult abuse form (SOC341) at this facility. LPA was greeted by Case Manager Argeli Lopez. LPA explained the purpose of the visit, reviewed files, and interviewed staff and client.

At 8:20am, LPA reviewed the facility’s schedule for 10/16/23. The document reports that clients involved in the SOC341 were loaded in a white van to attend Billiards during the PM schedule. Two staff members (S#1 and S#2) and six clients were on board.

At 8:27am, LPA reviewed the Personnel Report (LIC 500) dated for 10/13/23. S#1 and S#2 were listed on the report.

At 8:33am, LPA interviewed Program Director Bianca Pina concerning the incident reported. Program Director recalled the incident and explained that C#1 does have behavioral episodes. During transports, C#1 likes to sit by staff and may have been triggered when C#1 was unable to sit next to staff. Program Director stated that the staff-to-client ratio is 1:3.

At 8:40am, LPA reviewed client record. C#1’s current SVS Individual Needs and Service Plans addresses the client’s behavioral goals, plans, and progress.

At 9:05am, LPA interviewed S#1 who recalled the incident reported on the SOC 341. On the way to play billiards, S#1 sat between C#1 and another client with behaviors. During the outing, C#1 mentioned that C#1 wanted to go home but staff informed C#1 that they would be going to the park next. On the drive to the park, C#1 sat next to another client, got mad, and hit the window, seat, and C#2. .