Facility Evaluation Report

Licensing Program Analyst (LPA) Lydia Martinez made an unannounced Case Management visit to follow up on incident report submitted to Community Care Licensing on 01/30/2023. LPA was greeted and granted entry into the facility by Care Staff Pedro Canoza and explained the reason for the visit. Administrator Dizon Dexter and House Manager Eduardo Manikad arrived shortly after.

Incident report dated 01/30/2022 indicated that at 8:00am Staff 1 (S1) was preparing the Client 1's (C1) glucometer to check blood sugar when staff notices C1 was not in bed. Staff reported to Administrator and drove around looking for C1 at nearby stores and restaurants. Administrator instructed staff at noon to file Report with the Anaheim Police Department. At 4:15 PM Anaheim Police Officer showed up to the facility and took a report. On 01/30/2023, S1 received a call at noon from Garden Grove Police Department notifying that C1 was found and C1 will be dropped off at the facility.

LPA interviewed Staff 2 (S2) and Staff 3 (S3) who are live-in staff who stated C1 leaves or attempts to leave the facility about once or so a month and is found at nearby restaurants or a store when C1 has left. LPA reviewed C1's file; per Physician's Report dated 7/13/2020, C1 is able to leave facility unassisted. In reviewing C1's Individual Program Plan (IPP) dated 4/19/2022, states C1 "requires 24/7 supervision".

LPA Martinez received a copy of C1's Annual Behavior Date Summary which shows C1 had 30 incidents of Eloping from January 2022 to December 2022. From January 2023 to present, C1 has had 4 incidents of Eloping. None have been reported to CCL but one (1/29/2023) incident.

Based on the observations and interviews made, the following violation is being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted and a copy of this report will be emailed