Facility Evaluation Report

LPA conducted an announced visit to facility. LPA Interviewed Administrator regarding the SIR in process of being reported to Regional Center and APS over the phone, while LPA was at the facility on other business. LPA received the following information: Staff noticed bruising of unknown origin on Client C1. During a behavior C1 is known to hit self and others. At this point it was not known what incident might have caused the bruising found while C1 was performing ADL's with staff assistance. Administrator informed LPA that he was in the midst of investigating the bruising, LPA observed registered nurse perform physical assessment of client bruising. Staff attempted to have C1 state how he obtained the bruising, C1 would not respond how he obtained the bruising. While LPA was conducting interviews with administrator staff assisted C1 with attending his day program, while staff was escorting C1 to transportation C1 entered facility van and begin to strike himself in the face blooding up his nose and facial area. C1 was visibly agitated and inflicted self-injurious bleeding to areas in his face. LPA observe staff attempt to calm, resident however C1 became more agitated and it took several minutes to calm C1 , LPA did observe C1 strike staff. Administrator was able to assist staff in gaining control of the client LPA did not observe any physical restraints on client staff was able to verbally assist C1 in de-escalating agitation.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time.

An exit interview conducted with Ronald Bautista Administrator and copy of report provided.