Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek initiated a Case Management – Incident tele-visit for an SIR received at the Regional Office on 5/19/2020. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s visit investigation was conducted via FaceTime with Shawn Bailey, the facility administrator.

LPA Dulek previously called the facility and spoke with Shawn Bailey on 5/21/2020 at 9:21AM and conducted a telephone interview at that time. LPA asked Administrator for a copy of Client #1 (C1)’s behavior plan, which was emailed to LPA on 5/21/2020. LPA along with Tri Counties Regional Center Quality Assurance Specialist (QA) Liz Aced-Arnett conducted telephone interviews with three staff involved on 5/29, 6/1, and 6/2/2020. The LPA then conducted a FaceTime Case Management visit on 6/4/2020 to ensure health and safety of the clients in care. At the time of the visit, 3 clients and staff were on an outing. One sleeping client and one staff were present during the visit on the crisis side of the house. At 1:15PM, LPA observed all 6 bedrooms, 3 ½ baths, laundry room, kitchen and common living areas. LPA noted all physical plant areas observed in compliance with regulation at the time of the video visit.

LPA conducted an interview with Administrator and confirmed staff schedules were emailed to QA Liz Aced-Arnett and forwarded or copied to LPA. LPA will be in contact with Administrator to follow up regarding the incident.

A telephonic exit interview was conducted with Shawn Bailey, and a hard copy was provided via email for signature.