Sacramento Senior Living

Allegation investigated: ) The facility allowed excluded individuals to work in the facility. 2) Staff are forging resident documents. 3) The Administrator is not present at the facility for a sufficient amount of time.

Licensing Program Analysts (LPA) Kevin Gould made an unannounced inspection at Sacramento Senior Living (RCFE) on 7/15/26 at 11:00am to conclude the investigation of the above allegation and to deliver the findings. LPA Gould met with staff, Gabby Enriquez and together discussed the investigation details. Based on files obtained and reviewed during the investigation process, LPA Gould was unable to corroborate the allegation. LPA reviewed 6 resident files. LPA requested and obtained physician reports (LIC 602) for all 6 residents in care (see confidential name list LIC-811 dated 7/15/26). LPA Gould reviewed reports for each resident. Upon review, the department has no concerns for five of the six physician reports are being altered or fraudulent. The files reviewed appear to be completed by the resident’s physician or an appropriately skilled professional that are able to complete the forms per department regulations. Report Continued on LIC 9099-C. Unsubstantiated Additionally, LPA conducted interviews with three staff members and four residents. All staff interviewed denied excluded individuals presence at the facility and had knowledge they are not allowed at any licensed facility. The four residents interviewed denied witnessing any individuals identified in the complaint as being present at the facility or did not recognize photos of the identified individuals. All staff interviewed knows who the administrator is and identified her most recent date working as the previous Monday (two days ago). three of the four residents interviewed were able to identify who the facility administrator is and identified her most recent working date as the previous Monday. three of the four residents interviewed identified the administrator present on a regular basis. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations of Other are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies cited per California Code of Regulations, TITLE 22. Exit interview was conducted with facility staff. Appeal Rights were issued, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jul 15, 2026 · control 27-AS-20260211145702

Allegation investigated: ) Staff are not meeting residents hygiene needs 2) Staff leave resident in soiled briefs for an extended period of time 3) Staff isolate resident in room

Licensing Program Analysts (LPA) Kevin Gould made an unannounced inspection to Sacramento Senior Living RCFE on 6/17/26 at 2:20 to conclude the investigation of the above allegations and to deliver the findings. LPA Gould met with Licensee, Salote Lewis and together discussed the investigation details. Based on the interviews conducted during the investigation process and statements obtained during the investigation process, LPA Gould was unable to corroborate the allegations. LPA Gould conducted interviews with three residents and four caregivers, including the licensee/administrator. All staff members interviewed described consistent care plans for alleged victim including 1 hour checks for incontinence and daily showers due to the incontinence of the alleged victim. LPA has observed the alleged victim outside of their room, interacting with staff and other residents. LPA attempted to interview alleged victim but was not able to conduct an interview due to alleged victim being non-verbal. Other residents interviewed denied witnessing such incidents or provided statements that what was reported is no longer happening. LPA could not corroborate the allegation. Report Continued on LIC 9099-C Unsubstantiated Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations of neglect/lack of supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies is cited per California Code of Regulations, TITLE 22. Exit interview was conducted with facility staff. Appeal Rights were issued, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jun 17, 2026 · control 27-AS-20260515090756

Type of visit: Required - 1 Year

On 6/17/26 at 10:30am Licensing Program Analyst (LPA) Kevin Gould arrived at Sacramento Senior Living for the purpose of conducting a required 1 year annual inspection. LPA met with Administrator, Salote Lewis and together conducted a tour of the home. LPA and Administrator evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA observed a comfortable temperature in all bedrooms and common areas. LPA measured the water temperature, temperature measured at 113 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents. LPA observed the fridge/freezer temperature in the kitchen to be above regulations. Per resident statements this is a recent development and there is an additional fridge/freezer utilized for resident food supply. Licensee is in process of ordering a replacement fridge for the kitchen. Per California Code of Regulations, Title 22 there were no deficiencies cited during today's inspection. An exit interview was conducted, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jun 17, 2026

Type of visit: Case Management - Deficiencies

On 2/19/26 at 9:15am, Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced Case Management deficiencies inspection to address deficiencies observed while conducting a complaint investigation. LPA observed about 8 expired canned goods ranging from expiring in 2018 to 2025. LPA observed insecticide sitting on top of the fridge and unsecured from residents in care. LPA observed doorframe broken with a large piece missing from the door frame. Upon entering the home LPA inspected the home thermostats and observed the living room, kitchen and resident and staff room were observed to be at 66 degrees F. below the required temperature, LPA observed the temperature to be set at 83 degree and the heater is not working. LPA inspected the other thermostat and observed the temperature to be set below the required temperature of 68 degrees. LPA observed staff turn up the temperature and the heater was working in this part of the home. Per the California Code of Regulations, Title 22, the following deficiencies are cited. Exit interview conducted and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Feb 19, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(b)(1) · Plan of correction due date: Feb 20, 2026

Maintenance and Operation: The facility shall heat rooms that residents occupy to a minimum of 68 degree F, (20 degrees C).This requirement was not met as evidenced by LPA observations of thermostat in the facility and personal thermometer carried by LPA. LPA observed the temperature in the living room, kitchen, and one resident room to be 66 degrees, LPAs thermometer reads 63 degrees. LPA observed this heater not to be working. LPA also observed on the other thermostat, the heat was set to below 68 degrees which poses an immeadiate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Feb 19, 2026

Plan of correction: Licensee shall contact HVAC repair and provide LPA with an estimated repair date. Licensee shall also provide a written statement indicating the steps facility will take to ensure rooms are heated until all repairs are completed.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87309(a) · Plan of correction due date: Feb 20, 2026

Storage Space and Access: Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement was not met as evidenced by LPA observations of black plastic syringe of insecticide was left on top of the fridge unsecured from residents in care which poses an immediate health, safety and personal rights risk to residents.the state’s words, verbatim · CDSS document, Feb 19, 2026

Plan of correction: Licensee shall submit a written plan of correction indicating the steps facility will take to review requirements with staff and to ensure such items are stored in a central location secured from residents.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Feb 20, 2026

Maintenance and Operation: The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by LPA observations of the heater for part of the home is not working, LPA observed the thermostat set to 83 degrees and a temperature displayed of 66 degrees. LPA also observed a broken door frame missing part of the wood frame which poses an immediate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Feb 19, 2026

Plan of correction: Licensee shall contact hvac repair and provide an estimated repair date by the POC due date. licensee shall also repair the door frame.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87555(b)(8) · Plan of correction due date: Feb 20, 2026

General Food Service Requirements: All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This requirement was not met as evidenced by LPA observations of expired canned goods ranging from 2018 to 2025 which poses an immediate health safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Feb 19, 2026

Plan of correction: Licensee shall provide a written plan of correction with the steps facility will take to ensure all food is of good quality and not expired.

Type of visit: Case Management - Other

On 8/28/2025 at 2:15 PM Licensing Program Analyst LPA's Shakaricka Hughes and Pang Lee arrived at the facility to conduct a case management visit to the facility to deliver an Order to Licensee/Facility of Immediate Exclusion from Facility. LPA's met with facility staff Asena and explained the purpose of today's visit. LPA Hughes handed the Order to Licensee/Facility of Immediate Exclusion from Facility letter to Asena and explained that facility staff (S1), if present in the facility needed to leave immediately. Facility staff (S1) is to be removed from all shifts and disassociated from the facility in Guardian. An exit interview was held with facility staff Asena and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 28, 2025

Type of visit: Required - 1 Year

On 05/29/25, Licensing Program Analyst (LPA) Pang Lee arrived at the facility to conduct an unannounced annual inspection. LPA Lee met with administrator Salote Lewis and explained the purpose of the visit. The current census is 6 with 3 facility staff. This facility is a single story building licensed to serve six (6) non-ambulatory residents and approved for 2 hospice waivers. LPA Lee inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA Lee observed the facility to be free of odor, clean and in good repair. LPA Lee observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA Lee toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 115.3 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in the kitchen and was last serviced on 05/01/25. The last fire drill was conducted on 05/20/2. LPA Lee observed the facility has a has a public telephone in the and kitchen the facility has the required posters posted. Facility thermostat was observed at 78 degrees Fahrenheit. LPA Lee observed toxins located in the laundry room and kept locked and inaccessible to residents. LPA Lee observed sharp knives kept locked in the kitchen cabinet and inaccessible to residents. Continued LIC 809-C LPA Lee checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed 3 out of 6 resident medications and medication administration record (MAR) and it was complete. The first aid kit was checked and contained the required components. LPA Lee requested resident and staff files for review. LPA Lee reviewed 5 out of 5 resident files and they were complete. LPA Lee reviewed 2 staff files, and it was also complete. The following documents will be email to LPA by 06/05/24 end of day 5:00 PM: (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (4) LIC 610 Current Emergency Disaster Plan (5) Proof of Current Liability Insurance (6) LIC 500 Current Personnel Report As a result of this annual visit, the facility is in compliance with Title 22 Regulation. An exit interview was conducted with administrator Salote and a copy of these LIC 809 reports were provided to the facility.the state’s words, verbatim · CDSS document, May 29, 2025

Type of visit: Required - 1 Year

On 05/21/2024 at 8:28 AM, Licensing Program Analyst (LPA) Pang Lee arrived at the facility to conduct an unannounced annual inspection. LPA Lee met with direct care giver, Asena Motubula who then called administrator Salote Lewis to informed that CCLD is present. Administrator arrived to the facility approximately 30 minutes later. LPA Lee explained the purpose of today’s visit. Administrator Certificate # 6062098740 expires on 08/08/2024. The current census is 5 with 1 facility staff. This facility is a single story building licensed to served six (6) non-ambulatory residents and approved for 2 hospice waivers. LPA Lee inspected the physical plant including but not limited to the common area, kitchen, dining area, residents’ bedrooms, residents’ bathrooms, laundry room, staff room, garage, and outside courtyards of the facility to ensure compliance with Title 22 regulations. It was observed the facility was free of odor, clean and in good repair. LPA Lee observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA Lee toured the kitchen and observed the facility had sufficient seven-day non-perishable food supplies. It was observed that two-day perishable food supplies were not sufficient for 5 residents in care. Hot water temperature was measured at 122.1 degrees Fahrenheit in resident bathroom sink, which is not within the required regulation of 105 to 120 degrees Fahrenheit. During today’s visit administrator adjusted the water temperature and it then was measured at 114.1 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in kitchen and was last serviced on 04/03/2024. The last fire drill was conducted on 02/02/2024. LPA Lee observed the facility has a has a public telephone in the kitchen and the facility has the required posters posted. The facility has an infection control plan and an emergency disaster plan. Facility thermostat observed at 70 degrees Fahrenheit. LPA Lee observed toxins located in the garage were kept locked and inaccessible to residents. Continued LIC 809-C LPA Lee observed sharp knives kept locked and inaccessible to residents. LPA Lee checked medication storage and found medication to be locked away and inaccessible to residents. LPA Lee reviewed and compared 4 out 5 medication administration record (MAR) along with residents’ medications. Records reviewed indicated that 1 out of 4 MAR log was inaccurate. Resident 1 (R1)’s Capsaicin 0.075 cream medication was not documented on the MAR. Per physician's order (R1)'s Capsaicin cream is to be apply four times a day for pain. Direct caregiver and administrator stated that (R1)’s cream is applied on (R1); however, it is unclear if (R1)'s Capsaicin cream is being apply since it is not documented. The first aid kit was checked, and it was complete. LPA Lee requested resident and staff files for review. LPA Lee reviewed 5 out of 5 resident files and 3 out of 3 staff files and they were complete. LPA Lee reviewed staff criminal record clearances and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated to the facility. The following documents will be email to LPA Lee (pang.lee@dss.ca.gov) by 05/27/2024 by 5:00 PM by end of day: (1) LIC 308 Designation of Administrative Responsibility (2) LIC 500 Personnel Report (3) Copy of Administrator Certificate (4) LIC 610 Emergency Disaster Plan (5) Proof of Current Liability Insurance As a result of this annual visit, the facility is not in compliance with Title 22 Regulation, and the deficiencies can be found on the LIC 809 D page. An exit interview was conducted, and a copy of these LIC 809 reports, LIC 809-D page, Technical Assistant and Appeals rights were provided to the facility.the state’s words, verbatim · CDSS document, May 21, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Allegation investigated: Staff do not ensure that resident is admistered their medication(s) according to physician's instructions.

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to deliver findings on this complaint investigation. LPA Moleski spoke with facility administrator Salote Lewis over the phone and explained the purpose of the visit. This investigation consisted of interviews with facility administrator Salote Lewis, two staff members (S1-S2), and four residents (R1-R4), review of resident records, and observation. LPA Moleski reviewed medication administration records (MARs), centrally stored medication records, and medication labels for R1. During a visit on September 21, 2023, LPA Moleski observed that a nighttime dose of antibiotic medication was not given to R1 on the evening of September 1, 2023, according to R1’s MARs. All other nighttime medications were administered on that date, according to the MARs. [continued on 9099-C Substantiated During that same visit, LPA Moleski observed signatures missing for nighttime doses of three medications listed for the evening of September 20, 2023, and for daytime doses of two medications for the morning of September 20, 2023. During a visit on October 5, 2023, LPA Moleski observed four of R1’s medication bottles empty. S1 said staff had called to order refills but the pharmacies were running late. One of these medications, a 30-tablet bottle of an antibiotic, was started on September 2, 2023, according to R1’s centrally stored medication records. R1 was to take one tablet daily. According to R1’s MARs, R1 was given a dose of this medication each day from September 2, 2023 through October 3, 2023. Based on the start date recorded in R1’s centrally stored medication records, and based on the doses recorded in R1’s MARs, this medication should have run out on September 31, 2023, not on October 3, 2023. During the same visit on October 5, 2023, LPA Moleski observed in R1’s centrally stored medication records that R1 started a 30-capsule bottle of medication on September 2, 2023. This medication was not listed on R1’s MARs for the month of September. LPA Moleski reviewed hospital discharge orders for R1 from a hospital visit dated August 21, 2023 to September 1, 2023 which discontinued the medication. On R1’s MARs for October 2023, R1 was given daily doses of the medication from October 1 to October 5, according to the MARs. During the same visit on October 5, 2023, LPA Moleski interviewed a staff member (S1). S1 said R1 was not given doses of the medication from October 1, 2023 through October 3, 2023, and admitted to falsely marking the MARs as if medication had been given, though none was. S1 said there was no new start order for the medication. LPA Moleski interviewed a second staff member (S2). S2 said R1 had been given doses of the discontinued medication on October 4, 2023 and October 5, 2023. During the same visit on October 5, 2023, LPA Moleski observed that only two capsules of the medication remained of the 30-capsule bottle. Based on doses signed off in R1’s MARs, a minimum of 25 capsules should have remained as of October 5, 2023. S1 said S1 flushed an unknown quantity of capsules at an unspecified date. S1 said there were no witnesses to this act. R1’s medication destruction records were blank as of October 5, 2023. [continued on 9099-C] The department has determined the following as it relates to the allegation that staff do not ensure that resident is administered their medication(s) according to physician's instructions: Based on interviews, record review, and observation, the above allegation is SUBSTANTIATED. A finding that the complaint allegation is substantiated means that the allegation is valid because the preponderance of evidence standard has been met. This facility is being cited per 22 CCR Section 87465(a)(4). Due to being a repeat violation, a civil penalty in the amount of $250 was assessed. An exit interview was held with Lewis. Appeal rights and a copy of this report were left with staff member Eliesa Qiolele. The department has determined the following as it relates to the allegation that staff are discriminating against resident: Based on interviews, the above allegation is UNFOUNDED. A finding that the complaint allegation is unfounded means the allegation is false, could not have happened or is without a reasonable basis. An exit interview was held with Lewis and a copy of this report was left with staff member Eliesa Qiolele.the state’s words, verbatim · CDSS document, Oct 24, 2023 · control 27-AS-20230915165919

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(4) · Plan of correction due date: Oct 25, 2023

"The licensee shall assist residents with self-administered medications as needed." This requirement was not met as evidenced by: Based on observation, record review, and interviews, R1 was not given medication in accordance with doctor's orders, which poses an immediate health and safety risk.the state’s words, verbatim · CDSS document, Oct 24, 2023

Plan of correction: Licensee agrees to conduct a staff training regarding medication administration. Licensee shall send LPA Moleski a sign-in sheet for this training and send a copy to LPA Moleski. vincent.moleski@dss.ca.gov

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a case management visit in order to address deficiencies discovered during a complaint investigation. LPA Moleski spoke with facility administrator Salote Lewis over the phone and explained the purpose of the visit. During the course of a complaint investigation, LPA Moleski interviewed a staff member (S1). S1 told LPA Moleski that S1 flushed an unknown quantity of a resident's (R1) medication on an unknown date. During a complaint investigation visit on October 5, 2023, LPA Moleski observed in R1’s centrally stored medication records that R1 started a 30-capsule bottle of medication on September 2, 2023. This medication was not listed on R1’s MARs for the month of September. LPA Moleski reviewed hospital discharge orders for R1 from a hospital visit dated August 21, 2023 to September 1, 2023 which discontinued the medication. On R1’s MARs for October 2023, R1 was given daily doses of the medication from October 1 to October 5, according to the MARs. During the same visit on October 5, 2023, LPA Moleski interviewed a staff member (S1). S1 said R1 was not given doses of the medication from October 1, 2023 through October 3, 2023, and admitted to falsely marking the MARs as if medication had been given, though none was. S1 said there was no new start order for the medication. LPA Moleski interviewed a second staff member (S2). S2 said R1 had been given doses of the discontinued medication on October 4, 2023 and October 5, 2023. During the same visit on October 5, 2023, LPA Moleski observed that only two capsules of the medication remained of the 30-capsule bottle. Based on doses signed off in R1’s MARs, a minimum of 25 capsules should have remained as of October 5, 2023. S1 said S1 flushed an unknown quantity of capsules at an unspecified date. S1 said there were no witnesses to this act. R1’s medication destruction records were blank as of October 5, 2023. This facility is being cited per 22 CCR Section 87465(i). An exit interview was held with Lewis. Appeal rights and a copy of this report were left with staff member Eliesa Qiolele.the state’s words, verbatim · CDSS document, Oct 24, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(i) · Plan of correction due date: Oct 25, 2023

"(i) Prescription medications which are not taken with the resident upon termination of services, not returned to the issuing pharmacy, nor retained in the facility as ordered by the resident’s physician and documented in the resident’s record nor disposed of according to the hospice’s established procedures or which are otherwise to be disposed of shall be destroyed in the facility by the facility administrator and one other adult who is not a resident. Both shall sign a record, to be retained for at least three years, which lists the following:" This requirement was not met as evidenced by: Based on observation and interview with S1, S1 destroyed an unknown amount of R1's medications without witnesses, and without the presence of the facility administrator, and without recording the destruction as required, which poses an immediate health and safety risk.the state’s words, verbatim · CDSS document, Oct 24, 2023

Plan of correction: Licensee agrees to conduct a staff training regarding medication destruction. Licensee shall send LPA Moleski a sign-in sheet for this training and send a copy to LPA Moleski. vincent.moleski@dss.ca.gov

Type of visit: Case Management - Incident

On 10/20/23 at 1:30 AM, Licensing Program Analyst (LPA) Pang Lee arrived unannounced to conduct a case management regarding an AWOL incident which occurred on 10/13/2023. LPA Lee met with direct care staff, Dillon Williams, who then called administrator, Salote Lewis to informed that Community Care Licensing Department (CCLD) is present in the facility. LPA Lee explained the purpose of the visit. The census is 4 resident with one facility staff. LPA Lee reviewed staff criminal record clearances and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated to the facility. At 2:00 PM, LPA Lee toured the facility with direct care staff, Dillon Williams, to ensure the safety of the residents. LPA interviewed direct care staff, Dillon and reviewed incident report dated 10/16/2023. LPA Lee also reviewed (R1) LIC 625, Needs and Services and LIC 602 Physician's Report. Based on interview and record review it was determined that R1 exited the facility front door on 10/13/2023. Moreover, it was also learned that while staff 1 (S1) was doing rounds to check on the residents (S1) did not see (R1) in (R1) room or anywhere in the facility. Law enforcement was called, and a missing person report was filed. R1's LIC 602, Physician Report dated 09/25/2023 was reviewed by LPA Lee and it revealed that (R1) is unable to leave the facility unassisted. Interview with Administrator revealed facility's internal plan includes providing supervision for R1 and all other residents in care. Additionally, it was revealed through interview that R1 left the facility, and no facility staff was aware of (R1) whereabouts. It was also discovered that (R1) was approximately 0.8 miles away from the facility when law enforcement found (R1) and brought (R1) back to the facility. Based on today's case management, a citation is issued under Title 22, Division 6. An immediate civil penalty in the amount of $500 is issued in addition to citation due to absence of supervision. An exit interview was conducted with direct care staff, Dillon Williams. A copy of this report LIC 809, LIC 809-D and appeal rights was provided to direct care staff at the end of the visit.the state’s words, verbatim · CDSS document, Oct 20, 2023

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.312(d) · Plan of correction due date: Oct 27, 2023

1569.312(d)Basic services requirements: Being aware of the resident's general whereabouts, although the resident may travel independently in the community. This requirement was not met as evidence by: Based on file reviews and interviews, the Licensee did not ensure staff were aware of R1 general whereabouts as R1 was found by a law enforcement and returned R1 to the facility. This posed an immediate health and safety risk to R1.the state’s words, verbatim · CDSS document, Oct 20, 2023

Plan of correction: Facility Administrator agrees to conduct elopement drill and training for all staff by POC date 10/18/2023. Facility Administrator will also submit a plan to ensure residents general whereabouts are known by staff. Plans to include , but not limited to: location within the facility and documentation to indicate when checks are completed. Facility administrator will email LPA Lee pang.lee@dss.ca.gov POC by POC due date 10/27/2023 by 5 PM.