complaint·July 19, 2022

Interviews with relevant parties indicated that, on 2/1/2022, owner of facility dropper resident (R1) off at their house, which was 20-30 percent damaged due to a fire. Neighbors saw R1 inside the house by themselves and brought them back to their home. The police were then contacted (interviews are inconsistent with who contacted the police). Interview with Administrator indicated that R1 was taken to home by Administrator to retrieve a cell phone charger, which was found at their home. Administrator stated that they left R1 with the their neighbors while they went around the corner to get gas. Administrator stated that they were gone for 45 minutes and returned to the neighbors that had R1. When Administrator returned to the home, they found police had been contacted. Administrator stated that they did not know R1’s neighbors prior to excursion. R1’s Physician’s Report (LIC 602) dated for 12/16/2021 indicated that R1 has a primary diagnosis of dementia and is unable to leave the facility unassisted, with a note indicating that “due to dementia patient at risk for not remembering the way back.” Allegation: Facility did not notify resident's responsible party that resident left the community. Interview with relevant party indicated that they were not notified that R1 was leaving the facility and did not know of their absence until notified by R1’s neighbors. As of inspection conducted on 7/19/22, an incident report has not been completed for incident that occurred on 2/1/2022. Based on interviews conducted by the department and records reviewed, the preponderance of evidence standards have been met. Therefore, the above allegations are found to be SUBSTANTIATED. Per California Code of Regulations, Title 22 Division 6, Chapter 8, deficiencies are being cited on the attached 9099-D page. Exit interview was conducted with Assistant Administrator. A copy of this report and appeal rights were provided. The Assistant Administrator’s signature on these forms acknowledges receipt of these documents.