Facility Evaluation Report

On 3/9/23 at approximately 10am Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a case management related to an incident report received for an occurrence on 12/9/22. LPA Jensen was joined by Lincoln Ellis, Sharmaine Roberts and Cynthia Poulos from the San Joaquin County Behavioral Health Department.

LPA Jensen interviewed Licensee Lisa Evans and site manager Karen Edmond regarding an incident that occurred on 12/9/22. On that date at approximately 8:45pm, resident 1 (R1) became agitated and aggressive with staff 1 (S1) over not getting a cigarette, knocked S1 down and caused injuries that required medical attention. 911 was called and S1 was taken to the hospital. R1 was taken in to custody and is still in custody to the best of facility staff's knowledge.

LPA Jensen reviewed R1's pre-placement appraisal, functional capabilities assessment, Crisis Response Team (CRT) flowchart and charting notes for the date in question. No deficiencies are being cited during the course of this visit. ]

An exit interview was conducted and a copy of this report and confidential names list was given.