Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Hamilton conducted an unannounced case management visit at the facility. LPA was greeted at the front door by Caregiver, Maria Hernandez and granted entry after identifying herself. LPA explained the purpose of the visit.

The facility self-reported an incident regarding Client 1 (C1) (See LIC 811 Confidential Names List) to Community Care Licensing on October 29, 2021. The facility reported that on October 27, 2021, C1 eloped from the facility unnoticed and returned to the facility the same day with minor scrapes.

During today’s visit, LPA conducted interviews and requested client records. This case management needs futher follow up. No deficiencies were cited during this visit.

An exit interview was conducted with Caregiver, Hernandez and a copy of this report, LIC 811 and Licensee/Appeal Rights (LIC 9058 01/16) were provided via email. An electronic receipt of confirmation was requested to be sent upon receipt of the documents.