Incident investigation·October 8, 2025

On 10/08/2025, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced case management visit to follow up on an incident report that was submitted to CCLD on 10/03/2025. LPA met with Memory Care Director, Daisy Dizon, and Regional Operations Specialist, Caroline Frangieh, arrived later during the visit. LPA explained the purpose of the visit. The facility submitted a written incident report indicating on 09/27/2025, at approximately 9:30 AM, Resident R1 participated in a morning walk accompanied by activity staff S1 and other residents. S1 was unaware that Resident R1 was not to leave the facility without assistance. Staff S1 returned to the facility without Resident R1. At app roximately 5:00 PM the same day, Resident R1 returned to the facility accompanied by an individual from outside the facility. Resident R1’s physician’s report identifies Alzheimer’s dementia as the primary diagnosis. The resident’s mental status indicates that R1 is not able to leave the facility unassisted. Due to lack of care and supervision by facility staff, R1 was able to elope from the facility. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with the Regional Operations Specialist, and a copy is provided with appeal rights.