Incident investigation·June 5, 2021

Licensing Program Analyst (LPA) Yelena Avetisyan conducted an unannounced Case Management - Incident visit at the facility today in conjunction with a subsequent complaint visit of complaint control # 31-AS-20210121104029 . The purpose of this visit is to issued citation for absence of supervision observed by the LPA during the subsequent complaint visit. Upon arrival to the facility at 7:10 pm LPA met with staff Alan Kibombwe. LPA requested to speak with administrator. Staff stated that the administrator is across the street and asked if LPA would like for him to call her. LPA asked that administrator be called, however instead of calling the administrator via telephone staff member left the facility at 7:11 pm and walked across the street to call the administrator. For approximately 5 minutes the six residents of the facility were left without supervision. When staff returned at 7:16 pm LPA asked why staff did not use the phone to call the administrator. Staff stated that he left his phone at the facility when he went to talk to him earlier in the day. Per staff another caregiver was at the facility however when LPA asked to speak with the live in staff he did not open his door or respond. At 7:19 pm Administrator Roselin Finuliar stated that she did not know why staff member would leave the facility and not call her, LPA explained that staff did not have his phone and administrator stated that he should have used the facility phone. Per the California Code of Regulations (CCR), Title 22, Division 6, Chapter 8, the following deficiencies were observed and cited: (Refer to LIC 809-D). Exit Interview Conducted / Appeal Rights Discussed / A Copy of the Report Issued.