Facility Evaluation Report

On 10-4-22 at 2:50pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit regarding an incident which occurred on 8-31-22. LPA met with Administrator Christopher Walters and explained the purpose of the visit. Administrator departed due to a previous engagement and gave permission for facility manager (S1) to sign in his absence. LPA reviewed incident report with facility manager and interviewed Administrator.

Based on interview and record review, it was determined that Resident1 (R1) eloped from facility on 8-31-22 at approximately 4:30pm. It was further determined that facility staff were aware of R1's departure from the front door and running down the street, but lost sight and supervision of R1 despite attempts to locate him. According to record review and interview, law enforcement was contacted at approximately 6:00pm on 8-31-22. Incident was further reported to licensing department, and to R1's service coordinator within appropriate regulatory time frame. R1 was located by facility staff on 9-4-22 and returned home.

As a result of today's case management, citations are issued under Title 22, Division 6. An immediate civil penalty was issued today in the amount of $500 due to violation of absence of supervision An exit interview was conducted with Christopher Walters and a copy of this report was left with Christopher. Appeal rights explained and to be emailed.