Incident investigation·June 17, 2021

On June 17, 2021, at 1:10pm, Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced case management in response to an incident that the facility self-reported regarding a resident AWOL (Absent Without Official Leave). LPA met with caregiver Mely Garland, Licensee Carlito Guevarra showed up at a later time. CCLD was informed of this incident on June 14, 2021. LPA was provided with Resident 1's (R1) physician report prior to this case management. LPA interviewed caregiver (S1) and toured the facility. LPA opened each sliding door in resident's rooms along with garage door. Each door has an auditory device to monitor exits. S1 stated that R1 unlocked the garage door and went out of the facility when S1 and Staff 2 (S2) were attending to another resident. S1 and S2 did not hear the auditory device when the door opened, and this is when R1 went missing for 1 hour and 45 minutes. A deficiency of the California Code of Regulations, Title 22, Division 6, Chapter 8, Section 87464 is observed and cited on the following LIC809-D page. Appeal Rights given. This report was discussed and reviewed with Licensee Carlito Guevarra.