Facility Evaluation Report

Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced case management visit to amend a report on 10/9/2025 and re-issue the correct citation and $500 civil penalty for an elopement of Resident R1 that occurred on March 29th, 2025.

On April 1, 2025, LPA Tarin interviewed Licensee Zhang. Licensee stated, R1 was found on 3/31/2025 and they do not know where R1 was found. Licensee states he heard from R1's responsible party that R1 was found on Stevens Creek Blvd near a gas station, but does not know the condition of R1. Licensee states R1 was last seen on facility surveillance on 3/29/2025 at 7:21AM. On April 1, 2025, at approximately 4:32pm, local law enforcement was informed R1 was found at Stevens Creek Blvd and Cypress Ave. The Department reviewed R1’s physician’s report dated September 8, 2023, which states R1 is not able to leave the facility unassisted. Based on a Google Maps Review, the location R1 was found was 2.9 miles from the facility, without staff supervision. A Deficiency is being cited under Title 22 Regulation 87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities, see LIC809D for more information.

As a result, An immediate civil penalty of $500.00 is being assessed against the facility today for violation the absence of supervision, which resulted in R1 eloping from the facility.

Licensee stated he was being treated unfairly by the Department and refused to sign the reports. LPA explained to Licensee that his signature of the report acknowledged receipt of the report. Licensee states he would not sign the report and would be appealing the deficiency and civil penalty.

A deficiency is being cited during today's visit, see LIC809D. An exit interview was conducted with Licensee. A copy of this report and appeal rights were provided.