Follow-up·December 29, 2022

Licensing Program Analyst (LPA) Kayla Hilario conducted an unannounced Case Management Visit. LPA was allowed entry, met with, and described the purpose of the visit to Caregiver Celina Samonte. House Manager Evelyn Salazar and Assistant House Manager Lolita Tisbe arrived during the visit. All staff present have current criminal record clearance. LPA conducted a wellness check at the facility by touring the facility both inside and outside and observing that residents in care appeared appropriate for the facility. Today's visit is in response to the self-reported incident which occurred on 11/26/2022 regarding an AWOL of Resident 1 (R1 - see LIC811 Confidential Names List). According to the Special Incident Report (LIC 624), R1 was allowed to leave the facility unassisted to visit a family member on a public bus on Wednesday 11/26/2022 around 08:00 a.m. Facility staff were notified at noon, that the R1 did not show up by noon. Licensee followed appropriate AWOL procedures by notifying authorities in a timely manner and trying to locate the resident. However, records review and interviews with staff and outside sources, determined that the R1 should not have been allowed to leave on their own. A deficiency was cited during this visit of Title 22 regulation 87411. An 809-D page is attached to this Facility Visit Report. An exit interview was conducted with the House Manager Evelyn Salazar. A copy of this report and appeal rights (LIC9056 03/22), were provided via hardcopy at the conclusion of the visit.