Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management visit and Kayla Williams, Lead Registered Behavior Technician (RBT). The purpose of the visit was to follow up on two incident reports that the facility self-reported to the Department.

The first incident was reported on 10/14/2024 and occurred on 10/12/2024. The incident involved staff S1 and S2 entering resident R1's bedroom once per hour to check in on R1 instead of remaining in the bedroom to provide continuous supervision during the night shift from 7 PM to 7 AM. S1 and S2 left their telephone numbers with staff S3 and told S3 to call them if there was any issue with R1 between their hourly checks.

R1's Individualized Behavioral Support Plan (IBSP) states that when R1 is awake from 10:00 PM to 6:30 AM, R1 requires two staff members within 0-10 feet and in line of sight in bedroom or sitting outside R1's bedroom door. When R1 is asleep from 10:00 PM to 6:30 AM, R1 requires two staff within 0-10 feet or sitting outside R1's bedroom door within line of sight. The second staff will do visual check-ins with R1 every 10 minutes and also check in with the first staff.

The second incident was reported on 11/08/2024 and occurred on 11/07/2024. The incident involved resident R1 reporting that S4 touched R1's thigh. R1 stated that S4 told R1 that S4 would buy R1ice cream if R1 did not tell anyone about the incident. During visit, LPA conducted a telephone interview with Administrator (ADM) Stephanie Silva Santos, who stated that S4 has been suspended and there is an ongoing investigation. ADM provided LPA Marrufo with the police report number for the incident involving S4 and R1.

A deficiency was cited as per California Code of Regulations Title 22. See LIC809-D for more information. A civil penalty of $250 is being assessed for a violation repeated within 12 months. See LIC421FC for more information. This report was reviewed with Kayla Williams and a copy of this report and appeal rights were provided.