Follow-up·November 2, 2022

On 11/2/2022 at 2:25PM Licensing Program Analyst (LPA) L. Hall conducted an unannounced Case Management visit regarding an incident that was reported to CCLD on 10/20/2022. LPA met with Marcelina Badeo, Administrator and explained the purpose of the visit. Incident report for R1 was sent via email to LPA on 10/21/2022 for an AWOL. S1 stated that R1 went outside to smoke a cigarette and left the facility approximately 11:00PM. S1 stated there was one (1) staff and three (3) residents at the facility during the incident. S1 stated that R1 normally goes out to smoke a cigarette and staff will look out window to check on R1. During interview with S2 it was stated that he went to check on R1 in his room at approximately 11PM and R1 was not there. S2 was the only staff working that night of the incident. Physician's report dated 3/8/2022 and appraisal needs and services plan dated 3/23/2022 both indicate that R1 is not able to leave facility unattended and needs supervision. During record review LPA observed R1's file was incomplete. LPA reviewed and obtained the following documents: Admission agreement; appraisal needs and services plan, LIC500, Physician's report date 3/8/2022, and the Pittsburg Police Department case number. Continued on LIC809C. Continued from LIC809. LPA observed the following deficiencies: -LPA observed R1's file was incomplete. -LPA observed on R1's physician's reported it stated R1 was not able to leave facility unassisted. 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 penalties. Exit interview conducted. A copy of this report and appeal rights provided