Follow-up·October 28, 2021

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced case management visit. LPA identified herself and stated the purpose of the visit to Executive Director Amy Banaga. The facility self-reported an incident regarding Resident 1 (R1) to Community Care Licensing on October 16, 2021. The facility reported that on October 16, 2021, R1 left the facility (AWOL) and was returned to the facility by police. On today’s date, LPA toured the facility and conducted a health and safety check. LPA briefly interviewed the Executive Director Amy Banaga and requested copies of additional facility records. No deficiencies were cited at this time. An exit interview was conducted with Amy Banaga, to whom a copy of this report and the LIC9058 Licensee/Appeal Rights were provided via E-mail. An electronic read receipt verifies receipt of these documents.