Facility Evaluation Report

On 02/23/24 Licensing program analyst (LPA) Villegas conducted an unannounced case management visit to follow up on incident that occurred on 2/12/24 and was reported to the department. LPA met with Director Aniece J. Johnson as the purpose of todays visit was explained.

The case management visit consisted of the following: On 02/23/24 LPA obtained copies of the staff and client rosters, the following copies for C1; facesheet, Harbor regional center IPP dated 06/23/23, action plan summary, and communication logs dated; 07/25/23, 07/28/23, 02/07/24, 02/21/24, and 02/22/24. On 02/23/24 LPA obtained the following copies for S1; ID card,DSP job summary, employee rights, zero tolerance of abuse policy, statement acknowledging requirement to report suspected

abuse of dependent adults and elders, requirements for reporting suspected abuse or neglect acknowledgement, New employee orientation (Day1-4 training), and records of discussion dated 10/17/23, communication regarding code of conduct and use of profanity in the workplace, and a copy of previous SIR investigation dated 05/31/24. On 02/23/24 LPA interviewed Director (D1), Staff #2-5 (S2-S5), Witness #1-2 (W1-W2), and client #2 (C2). LPA was unable to interview S1, LPA left a detailed voicemail with call back information. As part of a health and safety check LPA conducted a tour of the facility, there were no immediate health and safety concerns.

Due to insufficient information available at this time, the incident need(s) further investigation.

Exit interview conducted with Director Aniece J. Johnso n, and a copy of this report was provided.