Facility Evaluation Report

Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced case management visit to follow-up on an incident reported to Community Care Licensing. LPA introduced herself, was granted entry into the facility, and met with Matthew Melena, to whom she disclosed the purpose of the visit. Mia Melena, Administrator, arrived during the visit.

Community Care Licensing received an incident report on February 14, 2022, in which it was reported that Client #1 (C1) [Staff was provided an LIC 811 Confidential Names List that identifies the client] was absent without official leave (AWOL) from the facility on February 9, 2022.

During today's visit, LPA conducted a health and safety check, interviewed staff, and obtained copies of facility records. No deficiencies were cited during today’s visit.

An exit interview was conducted with Mia Melena, Administrator, and a copy of this report and Licensee Appeal Rights (LIC 9058) were provided to the administrator, via electronic mail, following the visit. An electronic mail read receipt confirmation was requested to be sent to LPA upon receipt of the documents.