Incident investigation·November 18, 2021

Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced Case Management visit. LPA was greeted at the front door by Licensee Cabuco and was granted entry into the facility after identifying herself and disclosing the purpose of her visit. During today’s visit, LPA conducted a tour of the facility, obtained copies of resident records, and conducted staff interviews. The visit was initiated due to a self reported AWOL involving client #1, that occurred on November 16, 2021. The incident was submitted via form LIC 624 – Unusual Incident/Injury Report to Community Care Licensing (CCL), which was received in our office on November 17, 2021. Further Investigation is needed before determining findings. This report was discussed with Licensee Cabuco. A copy of this report, and Licensee Rights (LIC 9058 01/16) was provided to Licensee Cabuco via email. LPA requested an email read reply response to confirms receipt of these rights.