Follow-up on corrections·September 15, 2025

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a Case Management - Deficiencies visit at 10:23 AM. LPA met with Licensee Representative Carrie Acosta. Entrance interview conducted and the reason for the visit was explained. The purpose of today’s visit was to follow up on a self-reported incident that occurred on 09/06/2025. During today’s visit between 10:23 AM and 10:35 AM LPA conducted a brief physical plant tour to ensure there are no health and safety hazards and interviewed the licensee representative. LPA interviewed the Licensee Representative about the event that occurred on 09/06/2025. The Licensee Representative stated that resident #1 (R1) eloped from the facility at approximately 03:00 PM. The Licensee Representative was present at the facility at the time of the incident and attempted to locate R1 in the surrounding areas. R1 was found by law enforcement approximately thirty (30) minutes later and paramedics were contacted to assess R1. R1 was transported to hospital after refusing to return to the facility. R1 has since been moved out of the facility by R1’s family. The Licensee Representative stated that R1 was able to elope from the facility after a staff member turned off the auditory alarms while doing laundry. LPA conducted a physical plant tour and observed three (3) auditory alarms located on the front door, bedroom #1, and the kitchen back door to be turned off/non-operational. LPA informed the Licensee Representative that auditory alarms must be functional on all exterior doors. The Licensee Representative expressed understanding and agreed to replace/repair the auditory alarms on the identified exits. Additionally, LPA had a conversation with the Licensee Representative about the care and supervision of residents with special health needs. The Licensee Representative expressed understanding and agreed to submit their plan on how they will ensure adequate monitoring of facility exits to prevent future elopements. Continued on LIC 809C. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted and copy of the report was issued and appeal rights provided.