Incident investigation·January 9, 2026

On 01/09/2026 at 10:00 AM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to conduct a case management regarding an Elopement incident report received by the Dept on 01/07/2026. LPA met with the facility administrator Kimberly. The current census is 15 with 3 facility staff present. LPA’s interviewed the facility administrator and reviewed incident report dated 01/07/2026. Based on interview and incident report R1 left the facility unassisted. Per interview with facility administrator, there was 3 facility staff present at the facility. Law enforcement was not contacted, as the facility was not aware resident (R1) left the facility. Resident (R1) returned to the facility on 01/07/2025 and reported to facility staff that they left the facility. R1's LIC 602, Physician Report dated 05/15/2025 was reviewed by LPA Hughes and it revealed that (R1) is unable to leave the facility unassisted. Interview with Administrator revealed facility's internal plan includes providing supervision for R1 and all other residents in care. Based on today's case management, a citation is issued under Title 22, Division 6. An immediate civil penalty in the amount of $500 is issued in addition to citation due to absence of supervision. An exit interview was conducted with the facility administrator Kimberly. A copy of this report LIC 809, LIC 809-D and appeal rights was provided to direct care staff at the end of the visit.