Facility Evaluation Report

On 9/1/2023, Licensing Program Analyst (LPS) Grace Donato conducted an unannounced case management visit. LPA met with Caregiver, Jonathan Mendoza. LPA explained the purpose of the visit.

LPA received an incident report last 8/29/23 regarding a resident (R1) eloping from the facility. The incident happened on 8/27/23, R1 eloped from the facility around 1am and was returned by Police around 2 am with no injuries. Staff (S1) that currently resides on the facility, but not on shift, did not hear the alarm went off around that time.

While LPA was in the facility, R1 was currently having lunch in the dining area. LPA observed that all exit points have a loud alarm when door is opened. Facility also has a main gate which is open the whole day and closed during nighttime. It is unknown which gate R1 used to exit the facility premises.

LPA spoke with Licensee, Diana Covich on the phone. There was no reassessment done for R1 after the elopement. Licensee has scheduled a reassessment for the resident.There is no night supervision scheduled in the facility. Based on document review, R1 has wandering behavior.

Deficiencies are cited today as the facility did not ensure that residents won’t be able to leave the facility without assistance. Facility also didn’t make sure that R1 had a reassessment after the incident, this is to address any additional care that might be needed. Facility is also being cited for not having night supervision available even when there is a resident who have wandering behavior.

Deficiencies are cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report was discussed and a copy of this report and the Appeal Rights are provided.