Facility Evaluation Report

On 12-28-21 at 1:16pm, Licensing Program Manager (LPA) Michael Bilger arrived unannounced to conduct a case management visit for a reported incident occurring on 11-19-21. LPA met with Administrator Christopher Walters and explained the purpose of the visit. LPA reviewed record for Resident1 (R1) and interviewed administrator. Based on record review and interview. It was determined that on 11/19/21 at approximately 11:15pm R1 became physically and verbally aggressive towards staff, and exited facility. Staff followed R1 and notified police department for assistance. R1 returned to facility with staff supervision at approximately 1:30am. Administrator reported incident to regional department on 11/20/21. Based on additional record review and interview, it was determined that a client medical assessment for R1 to determine appropriateness for facility placement was not completed prior to R1's admission on 11/14/21. Based on today's visit deficiencies are cited under Title 22, division 6.

An exit interview was conducted with Administrator Christopher Walters and a copy of this report was left with Christopher. Appeal rights provided.