Facility Evaluation Report

On 6/20/2024, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of following up on an incident report submitted by the facility and received by Community Care Licensing Regional Office on 6/20/2024. Incident report indicates that on 6/9/2024, client (C1) had eloped from the facility and returning multiple days after on 6/13/2024. Facility staff properly contacted and filed missing persons report to the local police department. Although facility submitted incident report to Community Care Licensing, the report was not submitted within 7-days of occurrence.

Citation has been issued under Title 22 regulation, 80061(b) - Reporting Requirements.

The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal of rights provided.

A Civil Penalty for a total of $250 has been issued for a repeat violation within a 12-month period.