Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a case management visit to follow up on two incident reports that were sent to the Sacramento South Regional Office. Facility staff confirmed no residents or staff had any signs or symptoms of COVID-19 in the last 10 days. LPA Valerio was screened for COVID-19 symptoms along with temperature prior to being allowed entry.

Incident 1 occurred on 10/03/2021. Staff 1 (S1) was scheduled to work 11:00 PM - 7:00 AM. Staff 2 (S2) came in early at 6:30 AM. S2 did not see S1 anywhere on the physical plant. S2 immediately checked on the safety of residents in care. All residents were safe and sleeping. S2 informed Administrator Rebecca. Ombudsman, CCL, and Alta Regional Center was informed the morning of 10/03/21. Administrator conducted an internal investigation and found that S1 intentionally left the facility. Administrator reviewed cameras and saw S1 turning off the lights and exiting the facility. S1 was immediately fired from the facility. LPA Valerio provided technical assistance.

Incident 2 occurred on 10/30/2021. Resident 1 (R1) fell from his bed, which resulted in needed follow up care in the hospital. Administrator informed Alta Regional Center Service Coordinator and Community Care Licensing within 24 hours of the incident. R1 was observed to be happy and doing arts and craft during the visit. R1's cuts were similar to a paper cut and the doctor use Dermabond to cover the cut.

LPA Valerio observed the physical plant inside and outside to ensure compliance with Title 22 regulations. LPA Valerio did not observe any health or safety concerns. Emergency exits were free from obstructions. LPA Valerio interacted with staff and residents during the visit.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies are being cited during this visit. An exit interview was held, and a copy of the report was given to Administrator Rebecca Hammett.