Facility Evaluation Report

On 11-17-22 at 3:51pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit regarding facility file documentation. LPA met with Mothanna Saleh via phone and explained the purpose of the visit. LPA also met with staff1 (S1) and S2 and explained the purpose of the visit. During a complaint investigation for complaint #27-AS-20221110163839, LPA reviewed incident report for resident1 (R1). It was revealed through interviews and record reviews R1 eloped from facility on 11-9-22, and the incident report was not sent to licensing department per regulatory requirements.

Based on today's case management visit, citation is issued under Title 22, Division 6 and noted on LIC 809D. An exit interview was conducted with S1 and a copy of this report was left with S1. Appeal rights provided.