Follow-up on corrections·November 22, 2021

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct a Case Management visit. LPA met with Director Melina Nunez and explained the reason for today’s visit. Community Care Licensing received an incident report indicating that resident #1 (R1) left the facility on 9/1/21. On 11/22/21, LPA interviewed the Director Melina Nunez regarding the absence of R1. Director Melina Nunez acknowledge the absence without Leave (AWOL). Upon a review of the most recent Physician Report (LIC602) dated 6/28/21, it indicates that R1 is not able to leave the facility unassisted. The Unusual/Incident Report (LIC 624) dated 9/1/2021 stated that R1 removed the wonder guard prior to leaving the facility. R1 went out the back door of the facility and was found by staff approximately 45 minutes later in the neighborhood behind the facility. Turlock PD was called from a neighbor and arrived but didn’t file a police report of the incident. R1 has since got a bracelet that can be removed. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, the following deficiencies are being cited on the attached 809D during this visit. You are hereby assessed an immediate civil penalty in the amount of $500.00. If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed. The Director Melina Nunez was provided a copy of their rights (LIC9058) and their signature on this form acknowledges receipt of these rights. Exit interview held with Director Melina Nunez and report left.