Facility Evaluation Report

Licensing Program Analyst (LPA) Jason Lund arrived at the above facility unannounced to conduct a case management visit regarding an elopement episode on 8/7/2022 for resident (R1). LPA met with Administrator Belinda Guzman and explained the purpose of the visit.

LPA reviewed the Unusual Incident/Injury Report dated 8/8/2022 stating that R1 went AWOL on 8/7/2022. R1’s physician’s report dated 1/14/2020 stated that R1 cannot leave the facility unassisted. LPA also reviewed R1’s physicians report and noted that R1’s Physician’s report is outdated and medical assessment and a reappraisal done at least annually.

As a result of today's visit, deficiencies are cited under Title 22, Division 6. An immediate civil penalty in the amount of $500 is assessed due to repeat violation within a 12-month period. An exit interview was conducted with Administrator Belinda Guzman and a copy of this report was left with Administrator Belinda Guzman. Appeal Rights provided.