Facility Evaluation Report

Licensing Program Analyst (LPA) Ali Deniz conducted a case management regarding incident reports involving resident elopement. LPA met with Licensee, April thomas. Case management visit is being conducted to get more information on incident reports CCL agency recently received (05/06/2026 and 05/24/2026) from the facility.

There were two (2) elopement reported to CCL Agency first one submitted on 05/08/2026 which occurred on 05/06/2026 and second incident report submitted on on 06/01 /2026 which occurred on 05/24/2026. In the second incident the neighbor called the police and brought her back. R1 had no injuries, and was is back in the community shortly after.

Resident R1 has a diagnosis of dementia and according to medical assessment exhibits wandering behavior.

LPA had a discussion about staffing conditions in the facility. Licensee stated they are still working on hiring new staff members.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiencies, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Exit interview conducted. Copy of report, LIC809-D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Licensee. Signature on form confirms receipt of documents.