Facility Evaluation Report

On March 17, 2026, Licensee Program Analyst (LPA), Tremayne Barra made an unannounced case management incident visit. LPA was greeted and granted entry by facility staff. Executive Director, Teresa Mapilis met with LPA shortly after LPAs arrival. Teresa was informed of the purpose of the visit. Information received was pertaining to an elopement of Resident #1 (R1). During the investigation process LPA conducted interviews, record reviews, and made observations pertaining to the elopement.

During the visit, LPA conducted an interview with Executive Director Mapilis, and obtained copies of pertinent records. Per Mapilis, camera footage shows Resident #1 eloped from the facility through the back door on 3/10/26 on or around 7:45PM unsupervised. Caregiver #1 (C1) noticed at or around 10PM that R1 was missing from the facility. Law enforcement was notified. R1 was found in the brush in the field owned by the facility on or around 11:20PM by law enforcement. Incident occurred again on 3/17/26. R1 eloped from the facility on or around 10:30PM. Caregiver #2 (C2) noticed R1 was missing from the facility. Notified law enforcement on or around 1:10AM. R1 was found in nearby brush in the field near the facility. The facility has 24/7 alarms on exit doors.

Needs and service plan was updated on 3/11/2026. Plan states that frequent supervision and redirection would be given due to wondering on or off of the facility property. Exits would be monitored due to elopement risk. Facility did not provide sufficient staffing and supervision during 3/17/2026 incident per code 87463(J). R1 left the facility unnoticed for on or about 2 hours. As a result, the facility will be cited. An exit interview was conducted and a copy of this report, LIC 809-D, Confidential Names list (LIC 811), and Appeal Rights were reviewed and provided to Executive Director Mapilis.