Incident investigation·August 30, 2021

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management Visit to follow up on events which licensee self reported to the Community Care Licensing San Diego Regional Office (RO). LPA was welcomed by and identified himself to receptionist Elizabeth Cardenas. LPA then met and discussed the purpose of the visit with Interim Executive Director Kris Waluzsko. On 08-19-2021, the RO received two LIC624 Unusual Incident Reports regarding Resident #1 (R1) and Resident #2 (R2) being absent without leave from the facility (AWOL) [see LIC 811 Confidential Names list for a description of R1 and R2]. The first report stated that Resident #1 (R1) was observed across the street from the facility around 4:00 PM on 08-17-2021 unharmed, before being escorted back home by staff. The second report said Resident #2 (R2) was observed walking down the sidewalk in front of the facility around 1:30 PM on 08-18-2021 unharmed, before being escorted back home by staff. During today’s visit, LPA briefly toured the facility and performed a welfare check on R1 and R2. LPA interviewed R1, R2, contracted home care staff, and the facility administrator. LPA also obtained copies of pertinent facility care records. No deficiencies were cited during today’s visit. An exit interview was conducted with Waluzsko, to whom a copy of this report, the Confidential Names list (LIC 811), and the Licensee/Appeal Rights (LIC9058 01/16) were provided via E-mail.