Complaint Investigation Report

Interviews conducted revealed that during the incident on 12/08/2020, C1 was frustrated and left the facility, yet staff stayed with C1 at an appropriate distance. Staff stated that they were within 20 feet of C1. C1 allegedly approached a neighboring home but did not engage with the neighbor and returned to the facility. This incident was also documented in facility notes. Additional interviews and a review of video surveillance confirmed that C1 left the facility on approximately 12/10/2020 in the afternoon. Video surveillance revealed that C1 approached a door and asked for liquor, but was refused. Video surveillance documented C1 at the residence for approximately 60 seconds. During the encounter, there was no staff presence or intervention. There were no facility notes or documentation detailing that this incident transpired, yet video surveillance did not capture staff supervision.

Based on the information obtained, there is sufficient evidence to support the claim that facility staff did not adequately supervise C1. This allegation is deemed Substantiated at this time.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D):

Exit interview conducted, today's reports and appeal rights were reviewed and issued.