Follow-up on corrections·September 17, 2024

On 09/17/24 at 9:57 AM, Licensing Program Analyst (LPA) Pang Lee arrived unannounced to conduct a case management visit regarding an Absent Without Leave (AWOL) incident which occurred on 09/14/2024. LPA Lee met with care staff Nina Tuiloma who then called the designated staff, Diana Garcia to informed that Community Care Licensing Department (CCLD) is present in the facility. LPA Lee explained the purpose of the visit. The census is 9 with 2 facility staff. At 10:33 AM, LPA Lee toured the facility with care staff Nina, to ensure the safety of the residents. During the tour it was observed that the front door alarm is not in good repair. It is unclear if the alarm is broken or needing a new battery. LPA interviewed designated staff Diana and reviewed incident report dated 09/14/2024. Based on interview and record review, LPA Lee was informed that R1 switched off the front door alarm and left the facility unsupervised. Moreover, the administrator received a call from the resident’s family member informing that (R1) had been found and taken to Kaiser South. Based on (R1)'s LIC 602, Physician Report dated 09/12/2024 (R1) is unable to leave the facility without supervision. It was also learned that the facility staff was not aware that (R1) had left the facility until the family called and informed the administrator that the residents is at the hospital. Based on today's case management, a citation is issued under Title 22, Division 6. An immediate civil penalty in the amount of $1000 is issued in addition to citation due to absence of supervision. An exit interview was conducted with care staff Nina. A copy of this report LIC 809, LIC 809-D, LIC 421 IM and appeal rights was provided to care staff Nina at the end of the visit.