Facility Evaluation Report
Capacity90
Census31
Date signed06/05/2023 02:26:43 PM
Licensing Program Analyst (LPA) Jason Lund arrived unannounced to do a case management visit. LPA Lund met with Resident Care Coordinator Andrea Eldridge
LPA Jason Lund received an Unusual Incident/Injury Report (LIC 624) on 5/19/2023 from the facility stating that resident (R1) eloped from facility on 5/17/2023. R1’s LIC 602 dated 5/8/2023 states that R1 cannot leave the facility unassisted.
Per California Code of Regulations, Title 22, the following deficiencies, and immediate civil penalty have been issued for repeat violation.
Exit interview conducted and report provided. Appeals rights printed.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction