Follow-up·April 28, 2026

Licensing Program Analyst (LPA) Marcella Tarin arrived unannounced to conduct a Case Management-Other to follow up on a Case Management visit conducted on 12/29/2025 regarding an elopement of a resident on 11/16/2025. LPA met with Staff S1 Betzabel 'Betzy' Torres. S1 informed Licensees/Administrators Lusanta and Saaj Kaiyom of the visit. On 12/29/2025, the Department conducted a Case-Management incident visit to follow up on the elopement of Resident R1 that occurred on 11/16/2025. During record review of R1's record, R1's Appraisal/Needs and and Services Plan Dated 11/10/2025, R1's Background Information states "R1 has occasionally wandered away from the home." The Appraisal/Needs and Service Plan for R1's states staff will re-direct R1 if R1 is wanting to leave. LPA and Administrator/Licensee Saaj Kaiyom reviewed Title 22- 87463 Reappraisals and how resident's reappraisals "shall be updated in writing as frequently as necessary or once every 12 months... shall document significant changes in the resident's physical, mental, cognitive, behavioral, or functional condition." Administrators/Licensees refused to sign the report for today while LPA was writing the report. LPA stated to Administrators/Licensees that signing the report is acknowledging receipt of report. No deficiencies are being cited per California Code of Regulations, Title 22. A Technical Violation is being issued during today's visit. See LIC9102 for more information. LPA was unable to conduct an exit interview with Licensees/Administrators. However, a copy of this report was provided and the LIC 9102 was printed and handed to Licensee/Administrator Saaj Kaiyom.