Complaint·September 12, 2025

INVESTIGATION REVEALED THE FOLLOWING: Allegation #2: The facility did not report the incident to Licensing. The complaint alleges that the staff did not report incidents involving Resident #1 (R1) to Community Care Licensing. According to the reports, the facility failed to inform the appropriate authorities about (R1) eloping from the premises and subsequent hospitalization. No further information regarding this situation was provided. On September 12, 2025, between 10:18 AM and 12:15 PM, the Department interviewed staff members identified as Staff #1 through Staff #3. Three (3) out of the three (3) staff members were able to validate the incidents with Resident #1 (R1) eloping from the facility on September 7 and September 8, 2025. All staff statements were verified through the Facility End of Shift Reports (dated 09/06/25 through 09/08/25). (S3) admitted that the facility has not submitted an Unusual Incident Report (LIC 624) to Community Care Licensing regarding incidents involving (R1). According to the internal Facility End of Shift Reports, Resident #1 (R1) experienced an unwitnessed fall and was hospitalized on September 6, 2025. The following day, (R1) had another incident involving elopement, which resulted in injuries and another hospitalization on September 7, 2025. On September 8, 2025, (R1) eloped once more, prompting the dispatch of law enforcement. On September 12, 2025, between 12:16 PM and 12:33 PM, the Department interviewed witness identified as the power of attorney to (R1) as Witness #1 (W1). (W1) verified that facility staff notified (W1) of incidents involving (R1) by telephone communication. On September 12, 2025, the Department verified with the Community Care Licensing Regional Office that there have been no Unusual Incident Reports submitted for (R1). Based on the information gathered, there is sufficient evidence to support the allegation mentioned above. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), the above-mentioned deficiency was observed, and citation issued (ref. LIC 9099D). An exit interview was conducted with Sandy Iraheta, and copies of the reports were provided.