Facility Evaluation Report

On 12-23-2025 at 1:00pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit regarding an incident report dated and submitted to licensing department on 12-4-2025. LPA met with Administrator Christopher Walters and explained the purpose of the visit. LPA conducted brief interview with Administrator and reviewed incident report. LPA also conducted interview with resident1 (R1),and requested contact information for S3, S4, and S5. LPA also reviewed facility file documentation including Physician's report and individualized program plan (IPP) for R1.

Based on interview and record review, on 8-3-2025 at approximately 12:00pm, it was reported that R1 slapped S3 in the face during a behavior episode. On 12-3-2025, during a scheduled meeting, based on interview and record reviews, it was revealed that R1 stated to a regional center representative that S3 punched R1 in the face five times on 8-3-2025. Interviews further confirmed that S3 was removed from facility and has not been working with R1 since the alleged incident. Additionally, R1 has since moved to another facility owned by Licensee, and with no contact with S3. Administrator reported incident to licensing department on 12-4-2025.

Additional time is necessary to complete this case management. LPA will return at a later time for completion. No citations issued today. An exit interview was conducted with S2 and a copy of this report was provided. Administrator departed prior to completion of today's visit.