Facility Evaluation Report

Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced Case Management - Incident inspection at the facility. Tri-Counties Regional Center Quality Assurance Specialist (QAS) Liz Aced-Arnett was also present. Entrance interview conducted. Administrator Venie Gonzales arrived at the facility at approximately 10:20 AM.

The reason for today's inspection was to follow up on a self reported incident which occurred on 02/20/2022 pertaining to Client #1 (C1). On 02/20/2022, C1 informed staff in the morning that their shoulder hurt and staff observed C1's arm to be swollen. C1 was taken to the urgent care and was diagnosed with a dislocated shoulder. Staff reported no witnessed falls or incidents. C1 has a private bedroom. C1 was also unable to state how the injury occurred.

During today's inspection, the LPA and QAS conducted interviews with the Administrator, Staff #1 (S1), and C1 between 10:20 AM and 11:30 AM. Interviews revealed it was unclear how C1's injury occurred. The LPA and QAS discussed night time supervision with the Administrator. The facility has 24 hour awake staff. The Administrator stated staff check the clients at night frequently but there is no set policy on a specific number of times the client are checked at night. It was discussed with the Administrator quantifying how often staff are checking clients at night and documenting the staff checks.

No deficiencies were cited during today's inspection. The Administrator was unable stay for the entire inspection but was advised of the report findings. Exit interview and report reviewed with staff Rustum Placio. Report will be emailed.