Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra conducted an unannounced case management inspection and met with Licensee Tony Guevarra. The purpose of this case management inspection is to follow up on a phone call and self-report incident report submit to Community Care Licensing (CCL).

CCL received a call from Licensee on 6/27/22 and self-reported incident report on 6/28/2022 reporting an incident that occurred on 6/26/2022. Client (C1) went AWOL in the morning of June 26, 2022 the Administrator noticed C1 walking to the street towards the Starbucks store. Administrator stopped them and remind them to make sure to come back early and C1 replied “yes at 8:30pm”. Administrator noticed that C1 did not come back at the time agreed then contacted C1’s responsible party and filed a police report for a missing person case# 2206-27-006. During today’s visit LPA was informed by Licensee that C1 was still AWOL and the police have not been able to locate them. LPA was provided with C1’s Physician Report (LIC 602) dated 5/26/2020 which indicates that C1 can leave the facility without supervision. This is not the first AWOL attempt by C1 and there had been another incident. C1’s care plan dated 1/20/22 indicates that C1 is a very quiet person who doesn’t like to socialize. After LPA reviewed resident records, it was requested to the Licensee once C1 returns to update their care plan for review.

No deficiencies cited during today’s inspection.