Facility Evaluation Report

Licensing Program Analyst (LPA) Martha Arroyo conducted an unannounced Case Management – Incident visit for the purpose of investigating a self-reported incident report and SOC 341. Upon arrival, there was one staff and one client present. The Administrator, Marchelino Roos arrived shortly after and the reason for the visit was explained. Entrance interview.

On 12/27/2023, the Department received an incident report stating that on 12/26/2023 at approximately 12:47 a.m., the Administrator received a telephone call from management informing the Administrator that law enforcement was currently at the facility conducting a welfare check. This was in response to a call made to law enforcement from a resident claiming they were left unsupervised by Staff #1 (S1). At 1:20 a.m. when Administrator arrived at the facility, law enforcement had already left the premises. The Administrator proceeded to conduct interviews with the residents resulting in placing S1 on immediate verbal administrative leave to conduct further investigation. Further stated was that on 12/27/2023, a Quality Assurance (QA) designee conducted an internal investigation and it found that S1 had arrived at the facility at 12:00 a.m. but was not feeling well. At approximately 12:15 a.m., S1 had left the facility with the intention of obtaining medication since S1 was not feeling well resulting in leaving three residents unattended and unsupervised. However, after arriving to CVS, S1 found that it was closed and proceeded to drive to another CVS. Resident #1 (R1) and Resident #2 (R2) were awake and R1 called local law enforcement to notify them that they had been left alone at around 12:25 a.m.

On today’s visit, the LPA conducted a brief plant tour at 9:15 a.m., conducted an interview with the Administrator at 9:35 a.m., conducted a file review at 10:05 a.m., and obtained copied of pertinent documents.