Facility Evaluation Report

Licensing Program Analyst (LPA) JoAnn Rosales and Tri Counties Regional Center Quality Assurance Specialist (QAS) Liz Aced-Arnett conducted a Case Management visit to follow up on incidents that occurred at the facility in October and December 2020 which was reported via email by the Administrator to their Service Coordinator. LPA met with Administrator Cami Hershkovitz. 1 Client was at Day Program, 1 client was at Post Secondary School and 1 client was with their family during the facility visit. Administrator stated that the clients were clear to leave the facility per Ventura County Public Health.

Upon arrival to the facility LPA observed video cameras in the common areas of the facility. Administrator stated that the cameras have been disconnected. LPA advised Administrator that they will need to update their Plan of Operation and Admission Agreement to include the use of video cameras in the common areas of the facility. LPA let Administrator know that they will need to submit the revised Plan of Operation and Admission Agreement to Community Care Licensing (CCL) for review and approval.

Interview with Administrator on 5/17/22 starting at 11:30 am revealed that there was only one incident that occurred in October 2020 with their family member who lives at the facility and client #1 (C1). Administrator stated that they do not recall the actual date that it occurred and it is not documented. Administrator stated that they were outside of the facility and were the only staff at the time when their family member ran toward C1 who was sitting in a chair at the dining room table. Administrator stated that C1 saw the family member coming towards them and they jumped up and backed off. Administrator stated that their family member was not attacking C1 and did not body slam C1 as indicated in their prior email to their Service Coordinator. Administrator stated that C1 never fell and was not touched by their family member. Administrator stated that their family member was not trying to attack C1 and continued to run out the front door. Administrator stated that their family member had a staff from CABA (Center for Applied Behavior Analysis) agency supervising