Facility Evaluation Report

On 12-2-2025 at 1:30pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit regarding a facility incident report dated 11-10-2025. LPA met with program director Tanya Monge and explained the purpose of the visit. LPA reviewed incident report with program director and conducted brief interview with program director. LPA also reviewed individualized service plan (ISP) for resident1 (R1). Based on interview and record review, it was revealed that on 11-10-2025 at 1:10pm, R1 was walking out of program while R2 was walking in. R1 then turned around and struck R2 on the middle of R2's back. Staff assessed R2 for injuries and kept both residents separated from each other until residents' departure. Day program has since implemented a plan to keep both R1 and R2 in separate classrooms at this time as a precaution. Incident was reported to Licensing within regulatory time frames, however was not reported to Ombudsman and local law enforcement per regulatory requirements. LPA reviewed ISP for R1 to ensure updates based on latest behaviors of R1. Additionally, LPA reviewed care notes pertaining to R1.

At this time, facility is continuing to document behaviors for staff awareness of behaviors and providing adequate supervision to ensure safety of residents in care. As a result of today's case management citation is issued under Title 22, Division 6 and noted on 809D. An exit interview was conducted with program director and a copy of this report was provided. Appeal rights provided.