Incident investigation·November 3, 2023

At approximately 1:30PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Case Management - Incident Visit and met with Executive Director/Administrator, Angie Boucher-Turin. The purpose of the visit was to follow up a self-reported incident that were submitted to Community Care Licensing (CCL). Incident Report 1/SOC-341: CCL received an incident report/SOC-341 report on 10/25/2023. Reports state that on 10/23/2023, Resident 1's (R1) Responsible Party informed the Executive Director of a stolen diamond necklace. Facility made all appropriate notifications per regulation. Per conversation with Executive Director, the facility is currently conducting an extensive internal investigation regarding the missing jewelry and are communicating regularly with the San Rafael Police Department and R1's Responsible Party. LPA was provided with documentation related to the investigation. No Deficiencies Cited during visit. Exit interview conducted. Copy of report and LIC811 (Confidential Names) discussed and provided to Administrator. Signature on form confirms receipt of documents.