Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management Visit and met with Administrator (ADM) Margie Villanueva. The purpose of the visit was to both follow up with the fire that occurred at the facility on 07/16/2024 and an Incident Report submitted to the Department on 09/27/2024 reporting that resident R1 attempted to commit suicide at the facility by consuming a bottle that contained a mixture of water and bleach.

During visit, LPA observed the outdoor area and observed the backyard fence to be fully repaired. LPA observed chairs and tables in the outdoor area. LPA took photographs of the fence and backyard smoking area. LPA observed the tables had ashtrays on them. LPA recommended during visit for ADM to purchase cigarette collector receptacle containers and place them in the backyard smoking area.

LPA Marrufo interviewed ADM about R1's attempt to commit suicide at the facility on 09/25/2024. ADM stated that R1 approached ADM's spouse, who is also a Licensee of the facility, and handed a bottle to ADM's spouse. ADM stated R1 asked ADM's spouse to smell what was inside the bottle and then tried to forcibly take the bottle back and tried to drink it. ADM stated ADM's spouse was trying to prevent R1 from consuming the contents of the bottle by trying to take the bottle from R1's hands. ADM stated ADM's spouse called 911 for R1. ADM stated the bottle had a mixture of water and bleach. ADM stated R1 was sent to the hospital and is currently at a crisis residential facility.

ADM stated that the day prior to R1's suicide attempt, R1 had requested bleach from ADM to wash R1's sink. ADM provided R1 with a small spray bottle filled with mostly water and some bleach. ADM stated that the bottle ADM provided to R1 was the same bottle R1 tried to drink from when R1 attempted suicide. LPA Marrufo took a photograph of the bottle that ADM stated to have provided to R1. An Advisory Note was issued. See LIC9102 for more information. A deficiency was cited as per California Code of Regulations Title 22. See LIC809-D for more information. This report was reviewed with ADM Margie Villanueva and a copy of this report and appeal rights were provided.