Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to obtain information regarding an Incident Report submitted on 5/12/2024 on 7/10/24 at 3:30p.

The incident report indicated that resident #1 (R1) upon arrival to the facility from an outing in the community dashed out the van door and ran towards the shopping center. Staff was able to follow to a certain point, however, due to traffic laws could not keep up with the resident. Staff reported R1 missing to law enforcement and stated the direction and was told they already had someone fitting the description and to come pick resident up from a clothing store. Resident was located and picked up from the police in front of the store, however, the resident was having a behavior in which personal shoes were discarded. Staff could not locate the shoes that R1 threw away. R1 had more shoes at the facility and more were bought after which R1 discarded 2 more pairs of shoes while at the facility.

Based on staff losing sight of the resident, a deficiency shall be cited during this visit.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, the following deficiencies are being cited on the attached 809D during this visit.

If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed.

The Administrator was provided a copy of their rights (LIC9058) and their signature on this form acknowledges receipt of these rights. Exit Interview held and a copy was provided.