Incident investigation·December 23, 2021

Licensing Program Analyst (LPA) Lopez conducted an unannounced case management inspection and met with Administrator, Paul Oseso. The purpose of the case management inspection was to obtain additional information regarding a self reported incident submitted to Community Care Licensing (CCL) on 12/6/21. CCL received an incident report reporting an elopement. Resident #1 (R1) eloped from facility on 12/6/21. Staff immediately alerted staff to locate R1. Staff #1 (S1) drove down the street and found R1. R1 was brought back to facility. Facility contacted R1's responsible party and doctor. According to R1's Physician Report, R1 could not leave facility unattended. Facility conducted staff training and will monitor residents closely. LPA conducted interviews and received documentation during today's inspection. As a result of this visit, the following deficiencies were observed, see LIC 809-D for deficiency cited. Civil Penalty applied for $250.00 for repeated violations within 12 month period for Regulation 1569.312(d) previously cited on 10/18/21. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. 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. Report given.