Facility Evaluation Report, 09/27/2023 — Tkas Guest Home, Stockton CA

On 9-27-23 at 3:00pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management regarding absence without leave (AWOL) incidents which occurred on 6-24-23 and 8-6-23. LPA met with Administrator Adetayo Kokumo and explained the purpose of the visit. LPA reviewed incident reports and physician's report for resident1 (R1) and R2. LPA also interviewed Administrator. Based on record reviews and interviews, the following incidents occurred:

Incident #1: On 6-24-23, according to incident report dated 6-25-23, resident1 (R1) exited facility at approximately 12 noon on 6-24-23. R1 was admitted to facility at approximately 7:00pm on 6-23-23. Based on interview, R1 was observed by staff to be laying in bed prior to 12 noon. Staff member on duty went into the kitchen to prepare meals and later checked on R1 to determined R1's whereabouts. Staff member then noticed R1 was not in his room. Staff member searched throughout the facility inside and out, and drove throughout the community to search for R1. R1 was unable to be located resulting in an absence of supervision. Staff member then called police to file a report. At this time, R1 has not been located. Physician's report reviewed states R1 is unable to leave facility unassisted.

Incident #2: On 8-6-23, according to incident report, resident2 (R2) became combative with another client and a staff member. R2 shoved staff1 (S1) and continued to engage in yelling. R2 then proceeded through facility door and walk down the street. S1 on duty proceeded to follow R2 down the street until R2 began running at which time S1 lost sight of R2 resulting in an absence of supervision. S1 then notified police to file a report. R2 was located and is now currently residing in the facility. Physician's report reviewed states R2 is unable to leave facility unassisted.

As a result of today's case management, citations are issued under Health and Safety Code, chapter 3.2. An immediate civil penalty in the amount of $500 is issued due to occurrence of absence of supervision. An exit interview was conducted with Adetayo Kokumo and a copy of this report was provided to Adetayo. Appeal rights provided.