Incident investigation·July 15, 2021

On 7/15//2021 at 1:05PM, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct a case management visit regarding an incident report received on 7/9/2021. LPA met with Executive Director, Gina Velayo and explained the reason for the visit. Incident report dated 7/8/2021 revealed that R1 AWOL'd and facility notified R1's responsible party. R1 was found by On-Lok driver approximately one (1) hour later and escorted to the clinic, Interviews with staff revealed that R1 left the facility during the afternoon bingo activity. S1 stated that facility staff looked for resident inside, outside and in the neighborhood, but unable to find R1. Staff noticed a window in the dining room was open, screen was torn, a chair placed in front of the window, and determined that is where R1 exited the facility. R1 was brought back to the facility from the clinic. S1 was able to provide LPA with physician's report for R1. S1 did not have any other records for R1. LPA requested the following documents: admission agreement, pre-placement assessment, and appraisal needs and services The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalty. Exit interview conducted. A copy of this report and appeal rights provided.