Incident investigation·June 14, 2023

This unannounced case management visit is being conducted by Licensing Program Analysts (LPAs) Ruth Martinez and Dwayne Mason to follow up on an incident reported to CCLD on June 03, 2023. LPAs met with Rosie Nakadaira, Executive Director and explained the purpose of today’s visit. Incidents were self reported regarding R1’s incidents on June 03, 2023. During today’s visit, LPAs interviewed staff, toured the physical plan to the facility and obtained copies of pertinent documents. On June 03, 2023, at approximately 8:30am during resident head count prior to lunch staff realized R1 was not accounted for. Staff immediately notified management, POA, primary physician and police department. Facility received a call from the police department to notify them that resident had been found. R1 was found at 2:00pm at the bus stop 10 minutes away from facility by police department and staff returned R1 to the facility on the same day. Per Executive Director in house training was provided to facility staff on elopement, providing close supervision to resident, and working with primary physician on care for R1 for any changes. Based on staff observation there was no injury and seemed unharmed. There has not been another episode with R1 since incident. Resident is in the community and is doing well. facility staff has modified resident head count to more frequently and provide monitoring to R1 as often as needed. LPAs found that facility acted appropriately and in a timely manner to address the incident and all other immediate attention to incident in question. LPA did not observe any immediate and/or safety risks in or out of the facility. Based on the observations made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations . This report was reviewed with Administrator and a copy of the report was provided and left at the facility.