Routine inspection (multi-day)·May 15, 2023

License Program Analyst (LPA) Shannan Hansen arrived at 8:45 AM to complete an unannounced annual inspection and met with Kari Oxford, Administrator. There is a total of 29 memory care residents. LPA continued file review of five personnel files and it was revealed that 3 (S1, S2, & S3) of the 5 staff that are required to have First Aid certification per Title 22 Regulation 87411(c )(1) did not, (see LIC 809-D) and 2 of the 5 staff (S2 & S3) sampled for review were not associated to the facility as required by Title 22 regulations 87355( e)(2) (see LIC 809-D). LPA reviewed centrally stored medication record and conducted staff interviews to complete this annual inspection. During inspection LPA followed up on elopement that was self reported to community care licensing (CCL) on 5/12/2023 that on 5/11/2023 at approximately 1:10 am resident (R1) had eloped from community. Facility staff and law enforcement conducted search and located R1. Law enforcement returned R1 to community approximately 1 hour later. LPA obtained records indicating R1 has diagnosis of dementia and is not to leave unassisted. LPA is issuing a citation today for R1 eloping from facility without staff knowledge on 5/11/2023. Facility has let staff go and increased staffing floor number, fixed electrical system caused by city power outage, conducted in service training on elopement, and has increased status checks. Continued on LIC 809-C LPA Hansen is requesting Licensee to update and submit the following documents by 6/05/2023 to SRRO: LIC 308 Designation of Facility Responsibility LIC 500 Personnel Record LIC 610 Emergency Disaster Plan (if changes) Control of Property Copy of Administrator Certificate Proof of Liability Insurance Appeal of Rights Given. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided..