Incident investigation·October 23, 2024

Licensing Program Analyst (LPA) Dwayne Mason Jr arrived unannounced for the purpose of conducting the health and safety case management visit to follow up on the Incident Report concerning a client not returning to the facility following Day Program. LPA was granted entry and met with Administrators Benly Bandola (AD2) and Brian Nazareno (AD1). LPA explained the purpose of the visit. The Department received the incident report concerning the above dated October 17, 2024. The facility filed a police report, notified family and MD. LPA toured the facility with AD Nazareno. Facility was observed to be clean, sanitary, and in good repair. Facility maintains a 2-day supply of perishable and a 7-day supply of non-perishable food. Medications are not managed by clients and administered at the facility. Sharps, toxins, and cleaning supplies were secured and inaccessible to the clients. Facility license is currently active. LPA reviewed and obtained pertinent documentation: Client Rosters/Staff Rosters, Special Incident Reports (SIRs), Client's Physician's Report, Admission Agreement, Resident Status Summary Form, Medication Administration Record for October 2024, 2024 Progress Notes, Consultation Reports from PCP dated 10/8/2024 and 9/10/24, and Appraisals. LPA conducted interviews with Administrator, Staff and Clients. No health and safety violations were observed. An exit interview was conducted with Administrator (AD1) Brian Nazareno, and a copy of this report was provided at the end of the visit.