Facility Evaluation Report

Licensing Program Analysts (LPAs) KaSandra Lopez and Esther Cortez, along with Tri-Counties Regional Center Quality Assurance Specialist (QAS) Liz Aced-Arnet conducted an unannounced Case Management - Incident inspection at the facility today due to Special Incident Reports (SIRs) received.

When the LPA and QAS arrived at 9:08 AM there were only two staff and three residents present. The Administrator Maria Lassiter was contacted at 9:12 AM and arrived at the home during the visit. The home is vendored by TCRC as a Specialized facility and all three clients in the home require 1:1 supervision between the hours of 6:00 AM and 10:00PM. The Administrator was advised during the visit that a deficiency is being issued today due to insufficient staffing.

The purpose of today's inspection is to follow up on a Special Incident Report (SIR) and Report of Suspected Dependent Adult Abuse Report (SOC341) received on 05/20/2023 pertaining to Client #1 (C1) and Staff #1 (S1). The alleged incidents occurred on 04/11/2023 and on approximately 04/17/2023. During today inspection, interviews were conducted with Staff #2 (S2) at 9:20 AM and the Administrator at 10:23 AM. S1 is currently on administrative leave. Record review was conducted and copies of pertinent records were requested. It was discussed with the Administrator that the SOC 341 completed was not cross reported to law enforcement. The Administrator agreed to cross report today. C1 arrived at the end of the visit from an outing and was interviewed at 1:41 PM. The LPAs have determined further investigation is needed and will return at a later date to continue the investigation.

During today's inspection, the LPAs and QAS were advised that Staff #3 (S3) was also on administrative leave due alleged abuse between S3 and Client #3 (C3) which occurred on 05/21/2023. Community Care Licensing received the incident report today while the LPAs were in the field. During today's visit an interview was conducted with Client #3 at 12:20 PM. Record review was conducted and copies of pertinent records were requested. The LPAs have determined further investigation is needed and will return at a later date to continue the investigation.

Exit interview conducted. Pursuant to Title 22 Division 6 of the CA Code of Regulations, the following deficiency was cited (refer to LIC 809-D). A copy of the report and appeal rights was provided.