Facility Evaluation Report

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced case management visit in regards to an incident report the department received on July 23, 2024. LPA met with Administrator (ADM) Anabelle Ablan and explained the purpose of the visit. (This Report is being amended to issue a civil penalty and deficiency that was inadvertently not issued during the case management visit.)

On July 23, 2024, the department received an incident report stating the resident R1 had eloped from the facility. The incident report stated the following; resident R1, who has a neurocognitive disorder, left the facility without staff noticing. R1 was found 3 houses away from the park sitting on one of the benches. The Incident Report states the incident took place on July 19, 2024, at approximately between 6am to 6:30am. The incident report also states the facility staff noted that R1 was not found in his/her bedroom and the sliding door in his/her room was open and the door alarm was turned off.

On July 23, 2024, LPA Manuel Monter arrived at the facility and rang the door bell at 3:15pm. LPA observed thru the front door's decorative glass that staff S1 was moving a table that was placed in front of the door. LPA also heard the staff S1 moving the table from the front door. LPA asked S1, why the table was in front of the front door. S1 stated it was because R1 had recently left the facility and R1 is trying to leave the facility. (Photographs were taken)

LPA went to observe resident R1's bedroom, (bedroom #5). LPA observed staff S1 removing a stick from the bottom portion of the sliding screen door for bedroom #5 (Resident R1's bedroom). S1 stated this was done because R1 was trying to leave the facility. LPA asked S1 to open the bedroom #5's sliding screen door. When S1 opened the door, the door alarm did not ring. LPA also observed one of the facility's living room couch inside bedroom #5. Staff S1, S2 and ADM stated the couch was placed directly in front of bedroom #5's sliding screen door, was to prevent R1 from eloping. Staff S2 stated it was the ADM's idea on how to prevent R1 from leaving the facility. (Photographs were taken). Page 1 Out of 2.