Facility Evaluation Report

On 4-12-22 at 2:12pm, Licensing Program Analyst (LPA) arrived unannounced to conduct a case management visit for an incident which occurred on 3/18/22. LPA met with Administrator Lourdes Fernandez and explained the purpose of the visit. LPA interviewed Administrator and requested Individualized Program Plan (IPP) for client1 (C1) and Physician's Report for C1. According to incident report received by licensing department on 3/21/22, C1 was admitted to facility on 3-18-22 and residing as a respite stay. On 3-18-22, C1 engaged in an inappropriate behavior which resulted in respite stay to be discontinued.

Based on interview, facility conducted an interview with regional center and C1's responsible person, but did not secure a physician's report prior to accepting C1 into care. C1 was sent back home with responsible person on 3-18-22.

Deficiencies are cited today under Title 22, Division 6, Chapter 1. An exit interview was conducted with Lourdes Fernandez and a copy of this report was given to Lourdes. Appeal Rights provided.