Facility Evaluation Report

On 4/11/25, Licensing Program Analysts (LPAs) K. Kaur and M. Yang conducted an unannounced case management-deficiency visit to follow up from case management visit on 8/20/2024 to address failure to provide care and supervision. LPAs met Executive Director, Amanda Kelsey.

On 6/11/2024 the Department received a written incident report from the facility, facility reported on 06/10/24 at 1:30AM Resident R1 was found by Visalia Police Department down the street. At 1:31 AM police notified the facility. Based on interviews conducted; Administrator confirmed the building egress alarm did go off however the two staff working were occupied by other residents. When staff responded to the alarm, resident R1 was not observed. Staff failed to conduct residents checks to ensure no residents were left unassisted.

Records reviewed indicated R1 had dementia and physician’s report recorded resident is unable to leave unassisted and needs supervision due to wondering.

Deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6.

An immediate Civil Penalty of $500 is assessed, see attached LIC421IM. Exit interview was conducted. A copy of this report was provided to Administrator via email, whose signature on this form confirms receipt of this report.