Facility Evaluation Report

Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced Case Management - Incident inspection regarding a self reported Unusual Incident/Injury Report (LIC 624) received on 04/15/24. LPA was joined by Tri-Counties Regional Center(TCRC) Quality Assurance Specialists (QAS) Patrick Brown. The LPA met with Administrator Erik Miranda and informed them the reason for the visit.

The LIC624 received on 04/15/24 pertains to an incident that occur on 4/14/24 where it was reported that two (2) staff (S1,S2) used a two (2) Man Pro-Act assist on Client #1 (C1). It was reported that C1 had asked the administrator over the phone if they could go play basketball and was explained it was pouring rain and after C1 slamed the phone C1 punched S1 in the face, grabbed S1's hand and twisted their pinky, and continued to attempt to hit and kick S1 as well as hitting their own face a couple of times. Furthermore, it was reported that staff move away and verbally prompted C1 to calm down, C1 continued to hit and kick and S1 called S2 to assist in a two (2) Man Pro-Act until C1 calmed down.

During todays visit the LPA and QAS interviewed two (2) Administrators and one (1) staff, and conducted a file review. Administrator Maria Miranda stated that a debriefing was done with the client during the de-escalation by staff and that they provided an additional debriefing training with staff on 04/16/2024 and sent documentation to the department of the training. Administrator Maria stated that they spoke with C1 on 04/16/24 regarding the incident, and was unaware it needed to be documented.

No immediate health and safety concerns were observed during the visit. If further investigation is needed the LPA will return at a later date. A report was provided to administrator Erik Miranda