Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management visit. LPA was welcomed by and identified himself to Receptionist Sharmaine Ta. LPA then met and discussed the purpose of the visit with Executive Director Kim Stratman.

Today's visit was in response to a self-reported AWOL (absent without leave event) involving Resident #1 (R1), received in the San Diego Regional Office on 02/17/2023 [see LIC 811 Confidential Names List for a description of person identifiers used in this report]. LPA performed facility tour / welfare check, collected records, and interviewed R1 and staff.

Per the LIC624 Incident Report which licensee submitted to CCLD: R1 lived in the facility’s memory care wing. On 02-13-2023, a concerned citizen observed R1 "a few blocks away" from the facility and phoned 911. Police found R1 unharmed/uninjured. Police notified R1’s responsible party and facility staff around 8:30 AM and then brought R1 back to the facility around 9:10 AM. Facility staff last saw R1 inside the facility around 7:00 AM. Staff did not observe R1 leave the facility and were initially unaware that R1 was absent.

CCLD visually verified R1 was unharmed/uninjured. Due to their baseline memory loss, R1 was not able to participate as a reliable historian/interviewee. Per their latest LIC602 Physician’s Report, R1 was diagnosed with dementia and “needs assistance” to leave the facility.

Per time and date stamped progress notes, personnel records, staff interviews, and licensee’s own internal investigation, during the incident in question, security camera footage showed Staff #1 (S1) exited the memory care wing while pushing a cart. S1 momentarily unlocked/deactivated the alarmed door to leave. R1 followed behind S1, before the door closed and re-locked, but S1 was unaware of this. R1 then exited the facility's lobby without other staff noticing. [CONTINUED ON LIC 809-C]