Complaint Investigation Report

was able to exit the facility through a side gate and down the driveway. Interviews revealed that R1 was located approximately one (1) milefrom the facility without staff supervision rolling in their wheelchair in the roadway. It was reported by staff, that due to staff attending to another resident, they did not observe R1 exit the facility.

Based on interviews, statements received, records reviewed and LPA's observations, the preponderance of evidence standard has been met. Therefore, the above allegation that Lack of Supervision resulting in Elopement is SUBSTANTIATED.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and/or the Health and Safety Code. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties.

Immediate Civil penalties are being assessed in the amount of $500 for lack of care and supervision of resident by facility staff.