Facility Evaluation Report

Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced Case Management - Incident inspection at the facility today to follow up on a self reported Special Incident Report (SIR) received. Tri-Counties Regional Center Quality Assurance Specialist (QAS) Katy Robison was also present. Administrator Joyce Abutin arrived at the facility at 3:21 PM.

On 06/15/2022, the licensee submitted a SIR regarding an incident that occurred on 06/14/2022 pertaining to Client # 1 (C1) and Client #2 (C2). It was reported that C1 suddenly ran towards C2 and grabbed C2 resulting in an altercation between C1 and C2. Previous record review revealed C1 had a history of attacking their peers in the home. On 06/15/2022, C1 moved out of the facility.

During today's inspection, the LPA and QAS conducted interviews with Client #3 (C3) and Client #4 (C4) between 2:50 PM and 3:20 PM. Both C3 and C4 witnessed the 06/14/2022 altercation between C1 and C2 after it began. No immediate health or safety concerns were observed during today's visit. No deficiencies are being cited at this time.

Exit interview and report reviewed with Joyce Abutin. A copy of the report will be emailed.