Facility Evaluation Report

On 10/4/2023 at 3:28 p.m. Licensing Program Analyst (LPA) B. Miranda arrived to the facility unannounced to conduct a case management inspection - incident inspection. LPA explained reason for inspection and met with Administrator (AD) Wendy Adler.

On 10/3/23, CCL received an Incident Report from the facility reporting R1’s behaviors towards staff. Facility previously submitted SIRs regarding R1’s behaviors towards staff. Administrator stated R1 has been at the facility for the past four years and has displayed behaviors since then. Incident report was revised, corrected, and given to LPA at the facility. LPA reviewed R1's current IPP which indicates R1 is to have a 1:1 staff member to meet supervision, care, and training needs.

LPA conducted interviews and reviewed records. LPA obtained a copy of R1's IPP and staff schedule for 10/1/23-10/7/23.

Administrator will provide Staff Roster, and current staff training for S1 & S2, copy of request for 1:1 funding, weekly direct care staff schedule by 10/6/2023.

Once all verification is received LPA will reviewed and if follow-up is need LPA will return at a later time.

Exit interview was conducted and a copy of this report was provided to Administrator Wendy Adler.