Facility Evaluation Report

Licensing Program Analyst (LPA) Albert Marin made an unannounced visit to continue the case management visit initiated last March 10, 2022. LPA met with Administrator (AD) Abdul Arastoo and stated the purpose of this visit.

Based on observation, file review and interview, about 9:00 AM of March 2, 2022, after facility check, staff members did not observed Client 1 (C1) in the facility. Staff reviewed sign out log and observed C1 did not complete a sign out entry before leaving the facility. Facility reported the C1 as a missing person to the local police department. On March 4, 2022, Facility received information that Client 1 was in the hospital for observation. On March 5, 2022, C1 was discharged back to the facility. As a follow up, AD Arastoo brought C1 to primary care physician. Per physician's report dated March 24, 2022, C1 was determined to be able to leave the facility unassisted; and able to communicate. On April 19, 2022, Community Care Licensing Division (CCLD) Orange Office received a report stating that on April 11, 2022 about 9:00 AM staff members observed Client 1 leaving the facility but did not come back by 10:00 PM. The following morning facility reported C1 as a missing person. On April 13, 2022 about 5:30 PM, C1 came back to the facility. AD made a follow up with care coordinator to set up another medical appointment follow up.

For this visit, LPA conducted medication review; and interview Client 1 and facility staff. LPA conducted consultation on California Code of Regulations (CCR) Section 85075.4 Observation of the Client.; and best practices in facility documentation. AD discussed the absentee notification plan and course of action with client that comes back in the facility after the incident.

LPA Marin conducted an exit interview with AD Arastoo; and copy of this report and CCR Section 85075.4 were left in the facility.