Facility Evaluation Report

At approximately 8:55AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Case Management - Other visit and met with Executive Director, Kimberly Humphrey. The purpose of today's visit was to conduct the facility's quarterly Non-Compliance inspection and to follow up on self reported incident reports that were submitted to the Santa Rosa Regional Office (SRRO).

LPA reviewed files for staff members hired from February 2026 to April 2026 related to the below concerns:

Administrator and Designated Representatives

LPA observed that identified staff members hired within this time frame had appropriate training documented or their training was scheduled to be completed. LPA requested for copies of scheduled training to be submitted to the Department once complete.

Community Care Licensing (CCL) received the following incident reports:

Incident Report 1 was submitted to CCL on 02/04/2026. Report states that on 01/31/2026, Resident 1 (R1) was observed sitting in a car in the facility's parking lot. The car belonged to another resident's family member. R1 was redirected back to the facility. Facility made all appropriate notifications per regulation.

Review of R1's care plan dated 12/31/2025 stated that R1 did not have a history of elopement. Per Executive Director, this Continued on LIC809C