Facility Evaluation Report
On 12/12/2023, Licensing Program Analyst (LPA) Arielle Pascua arrived announced to this facility to conduct a case management visit. LPA met with Facility Designated Administrator (FDA), Ryiesha Levingston and explained the purpose of the visit.
Current census was 4. A brief interview with FDA Levingston was conducted.
The purpose of this visit was to follow up on an incident that occurred at the facility on 11/30/2023.
On 11/30/2023, the department arrived at the facility to conduct an unannounced visit. During this visit it was observed by the LPA that R1 was exhibiting crisis behavior towards employees. At this time the LPA attempted to leave the facility where they were approached by R1 from behind and hit the LPA on the right side of their face. The LPA fell into an adjacent bush next to the facility where the LPA managed to de-escalate the situation by asking R1 to count forwards to 3. At the time of the incident, it was observed by the LPA that there was no staff who witnessed the incident or outside with the resident at this time. Interviews of staff present at the time of the incident also show that no staff persons came outside to witness the incident nor lend assistance in de-escalating the resident.
A review of R1's Individual Program Plan (IPP) and Individual Behavioral Support Plan (IBSP) conducted in November 2023 was conducted. R1's IBSP states that R1 is currently on a 2:1 support ratio with both staff in line of sight at all times and only one person actively interacting with them at a time. A review of R1's IPP confirms staffing. In addition, based on R1's IPP it stated that when R1 has an assaultive behavior, the facility is to use the Ukeru technique to help de-escalate the situation. The Urkeru technique shall include reassuring words and pads to help block strikes at facility staff.
Based on the observation and record review, per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, the following deficiencies are being cited on the attached 809D during this visit. If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed.Due to printer issues, a copy of this report was provided via email to the Facility Designated Administrator. A read receipt confirms retrieval of the report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction