Facility Evaluation Report

On 4/15/2024 Licensing Program Analyst (LPA) Jaynae Boyles arrived at the facility unannounced to conduct a case management to follow up on a recent AWOL at the facility. LPA met with facility Administrator Jennifer Boss and explained the purpose of the visit.

The incident occurred on 4/11/2024 where a resident, who was deemed unable to leave facility unassisted at around 4pm, had eloped in the afternoon without any staff knowing. While out the resident had an unwitnessed fall resulting in the resident sustaining a broken hip. A community member found the resident on the sidewalk and contacted 911. The facility was informed by resident's son later that afternoon at around 4:28pm.

As a result of the incident, the Department is issuing a citation on the attached LIC 809-D, per Title 22 Regulations. Also attached to the deficiency is an immediate civil penalty in the amount of $500, which is assessed for a violation of California Code of Regulations Section 87705(c)(4) . The licensee was informed that an Enhanced Civil Penalty is under review and may be assessed at a future date according to Health and Safety Code 1569.49.

Exit interview conducted. A copy of the report has been issued. Appeal Rights provided. Jennifer Boss signature on this report acknowledges receipt of these reports.