Facility Evaluation Report

Licensing Program Analysts (LPAs) Mandeep Kaur and David Marrufo conducted an unannounced Case Management visit and met with Administrator Byron Perryman. The purpose of the case management visit was to follow up an an incident report that the facility submitted to the Department on 06/03/2022. The incident report stated that facility staff observed at 8:00 AM on 06/02/2022 that resident R1 was missing from the facility. The incident report states that resident R1 was returned to the facility at 9:00 AM the same day of the incident.

LPA Marrufo spoke with Administrator Byron Perryman on 06/09/2022 and he stated that R1 left the facility prior to a staff being scheduled to operate the front desk at 8:00 AM. He stated R1 is not permitted to leave the facility without assistance.

R1's Appraisal/Needs and Services Plan states that R1 may not leave the building unassisted. R1's Physician's Report at the time of the incident states R1 is not able to leave the facility unassisted.

A deficiency was cited as per California Code of Regulations Title 22. See LIC809-D for more information.

This report was reviewed with Administrator Byron Perryman and a copy of this report and appeal rights were provided.