Incident investigation·May 14, 2025

At approximately 10:45AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct a case management visit in regards to an incident report submitted by facility on 04/23/2025. LPA met with Executive Director Alma Peralta and reviewed records. On 04/19/2025, while assisting with resident medications, staff, S1, observed resident, R1, in their room at approximately 5:30AM. At approximately 5:40AM, S1 was assisting another resident when they heard a noise around a corner. S1 went to investigate and saw R1 looking at them through a window from the outside. S1 observed the door to be unlocked and the door alarm was turned off. S1 opened the door and escorted resident back to their room. The noise heard by S1 was the door closing and R1 yelling to be let back in. Based on records reviewed, the door alarm was left turned off by kitchen staff the day prior. Facility updated procedures to ensure exit alarms are monitored to ensure they are operational. No citations issued during today's visit.