Incident investigation·April 11, 2022

Licensing Program Analyst (LPA) Angel Ascencio conducted a Case Management visit regarding an elopement that occurred on 4/8/22 for the above facility. LPA met with Administrator Luis Gonzalez. During the investigation. LPA interviewed Admin Luis Gonzalez and Administrative Assistant at 3:20 p.m and Staff #1 (S1) at 5:00 p.m. During the interviews, it was revealed that Resident #1 (R1) was sitting in the patio enjoying the sun. Staff went to their room to pick up tray after lunch and was not present. Staff went out to look for R1 around 12:40 p.m. at the patio and realized they were not there. S1 decided to walk to daughter place because they live close by and Admin Assistant took company van. Around 12:50 p.m., R1 was located about 1 block away from community alone with no supervision and no noted injuries. R1 was physically in the community at 12:55 p.m. LPA received a telephone call from Admin on 04/08/2022 at approximately 4:37 p.m. regarding the elopement incident. Interview with R1 could not be conducted as R1 was busy with other needs. LPA reviewed R1's LIC 602 Physician's Report dated 02/02/2022, it was revealed that R1 has a diagnosis of Dementia and a box was checked off by the Physician stating " Can't leave facility unattended." LPA also reviewed incident report dated 4/8/22, R1's Admission Agreement, Plan of Care and the facilities Plan of Operation regarding caring for Dementia Residents. 1 citations was issued during today’s visit. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report, citation page and appeal rights was provided via email to Admin.