Facility Evaluation Report

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced case management visit in regards to a phone call the Department received regarding R1 on June 14, 2024. LPA met with Health Services Director (HSD) John Doyle and explained the purpose of the visit.

On June 14, 2024, the Department received a phone call from facility Administrator (ADM) Karina Nevarez who stated resident R1 was discovered missing on June 13, 2024 around 9:30pm. ADM stated that R1 was admitted to the facility on March 2024. ADM stated R1's secondary diagnosis is early onset of dementia.

ADM stated that the resident likes to sit by the front but is always redirected back. ADM stated R1 resides in the assisted living section of the facility. ADM stated when staff were asked, no one saw R1 leave the facility and have knowledge which door was used by R1 to leave the facility. ADM stated that the family has been notified. ADM stated that SJPD with some facility staff were actively searching for the resident since yesterday and SJPD issued a SILVER ALERT (missing person).

The Department received a follow up call from the facility ADM, stating the resident was found was in the hospital since the night before, at 12:10am. ADM stated R1 used the front door and walked to the shopping center near the facility. ADM stated the store clerk contacted 911, when R1 was unable to answer questions about where he/she lived and his/her name. ADM stated R1 stayed in the hospital overnight. ADM stated R1 was going to be transferred to memory care, but they do not have any availability.

On June 14, 2024, LPA interviewed HSD. HSD stated the facility has 11 residents with dementia living in the assisted living section of the facility. HSD stated when R1 first moved in he/she would wander to the front or wander up and down the halls. HSD stated once R1 got new friends and joined activities, the wandering went down.