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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700690
Report Date: 09/07/2021
Date Signed: 09/07/2021 04:26:34 PM

Document Has Been Signed on 09/07/2021 04:26 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:CROSSPOINT RESIDENTIALFACILITY NUMBER:
342700690
ADMINISTRATOR:OFOSE, PATRICKFACILITY TYPE:
735
ADDRESS:7504 MOUNTAIN OAK WAYTELEPHONE:
(916) 333-1004
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY: 6CENSUS: 6DATE:
09/07/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:56 PM
MET WITH:Michael OgenahTIME COMPLETED:
04:45 PM
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On 9/7/2021 Licensing Program Analyst (LPA) Williams conducted an unannounced case management visit due to Administrator notifying LPA of an AWOL resident (R1) this morning at 9:06am by email and phone call. Due to COVID precautions, LPA is COVID tested weekly and screens self for symptoms daily, LPA also wore surgical mask, used hand sanitizer prior to entering facility, and upon entering facility staff took LPAs temperature.

After speaking with Administrator and care staff, as well as viewing R1's Physician Report and personal file, LPA learned that R1 is able to leave the facility on his own, but is asked to return nightly. R1 left facility on 6:33pm on Monday 9/7/2021 with other housemates but did not return with them. Earlier that evening, Administrator found the resident with alcohol and took it away to hold it for him, as he cannot consume alcohol in facility. R1 also stated "I want to go see my family, they are waiting to celebrate my home coming, people need to know I am rich." R1 does not have a cell phone. R1 has been living at facility since Monday, 8/31/2021.

Facility staff checked nearby areas including local liquor stores. Staff notified Telecare, as well as the Sacramento Police Department who filed a missing persons report (Deputy Taylor 21-273517).

LPA asked to be notified of any information regarding R1 and will continue to check on the situation until R1 returns to facility.

No deficiencies are being cited as a result of today’s case management visit.

Exit interview conducted and copy of report left at the facility.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Jacob Williams
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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