Incident investigation·May 14, 2021

On 05/14/2021 Licensing Program Analyst (LPA) Allison O'Hollaren conducted an unannounced case management visit regarding a self-reported incident that occurred on 04/20/2021. Due to the Shelter in Place set forth by the Governor on March 17, 2020, LPA was not able to conduct the visit in person. The visit was performed by tele-visit. LPA spoke with Administrator, Samuel Tet. During the visit LPA spoke and reviewed incident with Administrator. Administrator confirmed that R1 left the facility unsupervised. Administrator stated R1 may have left through an exit door in R1's bedroom. The exit door did not have a working alarm. After the incident, Administrator activated alarms to all exit doors. Administrator emailed R1's records per LPA's request. The following deficiency was cited from the California Code of Regulations, Title 22. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report emailed.