Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon conducted a case management visit to the facility above due to a self reported incident at the facility. LPA met with back up to Administrator staff Rafael Mendoza. LPA explained the purpose of the visit.

LPA toured facility with staff and Tri-Counties Regional Center (TCRC) QA Miguel Magana.

Facility is clean , safe and sanitary. R1 eloped on 12/08/2022 early am. Facility staff last seen R1 at 3:45 AM. Facility staff on the AM shift went to wake R1 up prior to 6:00am to get R1 ready for work and it was discovered R1 had eloped out the bedroom window. Staff 1 (S1) attempted to call R1's cell phone. R1 was not answering phone when S1 was attempting to call R1. S1 tried to call R1 again at 10:15 AM and R1 answered, R1 stated R1 was in Texas and was going to go to Miami Florida for a few weeks and will return to the facility but did not give an exact date and time of return. R1 does take medications. R1 has been without medications while gone. R1 has not returned to the facility as of 12/20/2022.

LPA has requested records: LIC. 602 report, IPP for TCRC, incident report for R1 Elopement, R1's Needs/Services plan, R1's Behavioral Report and R1's Individual Service Plan. Staff provided all documents except R1's LIC. 602 and Needs and Services Plan as staff was unable to locate at the time of visit and will provide to LPA timely.

Based on the TCRC IPP R1 is supervised at work and at home.

Exit interview conducted, deficiency cited, copy of report and appeal rights emailed to the Administrator.