Facility Evaluation Report

Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Case Management - Incident visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Care Giver Valarie Carrillo. LPA also met with Administrator Sally Saif, who arrived later during the visit.

Today's visit was in response to two (2) LIC624 Incident Reports, which licensee self-submitted to the CCLD San Diego Regional Office (received on 12/28/2023). According to the LIC624: on the day of 12/9/2023, Client (C1) left the facility after an aggressive behavior, without permission from staff. C1 returned to facility on 12/13/2023. C1 was not taking any prescribed medication at the time of residency. According to the second LIC624: on the day of 12/14/2023, Client (C1) eloped quickly from the transportation vehicle providing transportation from her Adult Day Program to her residence. [See LIC 811 Confidential Names List for a description of C1.].

During today’s visit, LPA performed a facility tour and welfare check on clients in care. LPA also reviewed pertinent records and interview relevant staff.

The LIC602 Physician’s Report (dated 12/4/2023) was very sparse due to an emergency placement and did not indicate any restrictions. The Admissions Agreement (dated 12/4/2023) was agreed by C1 and indicates client may not leave unassisted.

According to C1’s latest IPP-Individual Program Plan (dated on 3/20/2023), their doctor determined that C1 was able to independently complete all personal care and is very knowledge of surrounding community.