Facility Evaluation Report

Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management visit to follow up on a incident, received by Community Care Licensing on 7/15/22. LPA was granted entry into the facility by Job Coach Victoria Majors. LPA then met with Rukhsana Gasque, Licensee, with whom she discussed the purpose of the visit.

The incident reported the absence without leave (AWOL) of Client 1 (C1) (See LIC 811 Confidential Names to identify C1) that occurred on 6/21/22. Per Licensee, the incident was reported to other outside agencies; however there was no unusual incident report submitted to Community Care Licensing. C1 was last seen at the facility on 6/21/22 at 9:00 AM, and reported AWOL to responsible party at 9:15 AM. Per Licensee and staff, C1 was found inside of the library across the street from the facility, however they refused to return to the facility. C1 returned to the facility at 11:30 AM.

Records reviewed determined that C1 is not allowed off the premises without supervision. Licensee contacted C1’s responsible party and an outside source to report the AWOL of C1.

During today's visit, LPA Williamson interviewed Joseph Baker, Assistant Program Director, Rukhsana Gasque, Licensee, staff, and reviewed the records for C1.

LPA, Assistant Program Director and Licensee, discussed reporting requirements and updating the facility's Absentee Notification Plan which is included in the Admission Agreement. No deficiencies were issued during today's visit.

An exit interview was conducted with Rukhsana Gasque, Licensee, to whom a copy of this report and the Licensee's/Appeal Rights (LIC9058 01/16) were provided.