Facility Evaluation Report

Licensing Program Analyst (LPA) Debbie Correia conducted an announced Case Management visit due to an incident report Community Care Licensing received on June 06, 2024. LPA Correia introduced and identified herself to DSP Skye Hampton and explained the purpose of the visit.

During today's visit, LPA observed clients in care and conducted a staff interview.

The visit was in response to a self-reported client AWOL which occurred on June 6, 2024, at approximately 3:00 AM. An interview conducted with facility staff confirmed the details of the incident listed in the LIC 624. Based on LPA’s review of facility records and interview with staff it was determined that staff did not comply with the requirements of their facility Absentee Notification Plan. Deficiency is cited per California Health and Safety Code on the attached 809D form.

An exit interview was conducted with DSP Hampton. A copy of this report, the LIC 809-D, and the Licensee/Appeal Rights (LIC9058 03/22) will be provided to Licensee at the conclusion of the visit.