Follow-up on corrections·June 27, 2025

Licensing Program Analyst (LPA) Cynthia Tamayo conducted an unannounced case management deficiency visit at the Regency Place II on June 17, 2025 at 2:10 P.M. LPA met with Administrator Damion E Anderson and informed them of the purpose of todays visit was to follow up on the AWOL for Sally Ebersole (R1) on 6/12/2025. An SIR was received for R1 informing R1 exited the facility unassisted (AWOL). current LIC 602 (dated 11/5/2021) indicated resident cannot leave facility unassisted. Based on record review facility was conducting hourly checks since 5/2025 for R1 due to daughter request for supporting medical verification. Hour check Log from 6/12/25 shows resident was checked on at 6:00PM at the note indicates she was in the lobby. The Med-Tech informed the S1 that R1 stated "I am going to my room". Security Camera's show resident exited the back door at 6:15PM and was found around 6:30 PM. S2 stated R1 told them they where leaving the facility to visit their daughter. S1 stated R1 was moved into Memory Care on 6/13/25. LPA toured the facility an exit door near room 27 to be propped open. S1 stated the house keeper sometimes props the door open during business hours (before 5;00PM when they are doing laundry. S1 stated they will make sure Hours keeping has a key in order to not prop doors open. S1 stated there is a sensor for the back door but there is no sensor for the door that leads to exterior as it is access for Independent Living Residents. The exit door in the dining room does not have an alarm and it locks at 7:00PM each day. There will be a new signal system put in place for exit doors. LPA Tamayo interviewed R1, and they declined leaving the facility and do not recall going out by themselves to visit their daughter. R1 is listed as Mild Cognitive Impairment (MCI). Administrator is requested updated LIC 602 and is pending Kaiser Physician appointment. Continued on 809-C LPA Tamayo reviewed Staff Roster, Staff Schedules, Resident File (R1). LPAs reviewed the Physicians Report for R1 which indicates R1 is unable to leave the facility unassisted. R1 does not have a history of elopement. Facility has conducted elopement training and has a prepared elopement bag. Additional alarms are being put in place by 7/27/2025. Based on interviews and records review, it was determined that R1 eloped from the facility without staff knowledge. R1's Physician Report (LIC 602) states that resident was not allowed to leave the facility unassisted. Facility staff shall have supervision of R1 and aware of R1’s general whereabouts at all times. Re-appraisal will be completed for R1. Deficiencies were observed and cited on the LIC 809-D pursuant to the California Code of Regulations, Title 22, and California Health and Safety Code. An immediate civil penalty of $500.00 is assessed for health and safety deficiency. Exit interview conducted, a copy of the report, 809-D and appeal rights given.