Incident investigation·April 29, 2021

Licensing Program Analyst (LPA) Sean Haddad conducted an unannounced Case Management inspection via tele-visit due to COVID-19 and for precautionary measures for the purpose of following up on the following incident that was self reported by the facility. LPA met with Supervisor Martha Marin and discussed purpose of the tele-visit. It was reported that on 4/20/21 Resident #1 (R1) and Resident #1 (R2) left the facility unnoticed. Later that day, R1's spouse notified facility staff that R1 and R2 had gone to CVS pharmacy, but it was getting late and they had not returned. Family members called the Fullerton Police Department. R1 had driven R1 and R2 and had gotten lost. A police officer found R1 and R2 and escorted them back to the facility. They were both returned safely and the family decided to take R1's car keys. During today's inspection, LPA conducted a health and safety check on R1 an R2 and found them to be at the facility in good health and observed no health and safety issues. LPA interviewed Martha who confirmed the details previously reported. Martha also stated R1 and R2 are independent and alert and are able to leave and return to the facility with no restrictions, but that R2 has mild dementia. When residents leave the facility, they are asked where they are going and when they are coming back. The facility maintains a checkout log for when residents leave overnight. Facility staff check to make sure all residents are present at 10:30 PM each night and if a resident is not present, facility staff will call the family. If they are not with the family, facility staff will call the police and notify the family. LPA requested copies of resident files for R1 and R2 and copies of the checkout log for the week of 4/20/21. At this time, no deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with facility representative. This report along with the LIC811 will be emailed and an electronic email read receipt confirms receipt of the report. Facility representative agrees to sign the report and email it back to LPA.