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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525002699
Report Date: 08/02/2022
Date Signed: 08/02/2022 03:45:40 PM

Document Has Been Signed on 08/02/2022 03:45 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:INSPIRED RESIDENTIAL WALKER RANCHFACILITY NUMBER:
525002699
ADMINISTRATOR:LEAK, RANDYFACILITY TYPE:
735
ADDRESS:12810 WALKER WAYTELEPHONE:
(530) 200-2909
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY: 6CENSUS: 5DATE:
08/02/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Chantelle Browning - house managerTIME COMPLETED:
02:45 PM
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08/02/2022 1:50 PM Licensing Program Analyst (LPA) Rebecca Knight, made an unannounced visit to the facility and met with house manager Chantelle Browning. The purpose of this visit was to conduct a case management investigation. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N95 Mask, gloves.

Today's meeting concerns an investigation into an incident report that was received from the facility on 07/27/2022 regarding an incident that occurred at the facility on 07/25/2022. It was reported that on 7/25/2022 3:00 PM Client 1 (C1) left the facility saying they were going for a walk. When house manager arrived on shift on 7/26/2022 it was reported to her that C1 had not retuned back to the facility. House manager searched for C1 in places that C1 frequents three times that day and was unable to locate C1. Staff called C1’s mobile phone but got no answer or response. At 4:30 PM the house manager called the sheriff and reported the client missing. C1 returned to the facility of his own accord at 5:30 AM on 7/27/2022.

It was learned that C1 is allowed to leave the facility unassisted. C1 goes for walks on most days. When C1 left the facility on 7/25/2022 they were in a good mood and staff expected C1 to come back as when C1 is in a good mood they always come back from their walks. C1 has friends that live right down the road from the facility that are a bad influence on C1 and C1 likes to go visit them.

In order to prevent this from happening again the facility has been counseling C1 to not spend time with the friends that are a bad influence. On 7/27/2022 C1’s conservator started working with Far Northern Regional Center on alternate placement for C1. Far Northern Regional Center has sent out referrals to two facilities and have not had a response yet. Six months ago due to C1’s elopement behavior the house manager has been recommending that C1 move to a more restrictive environment.

No deficiencies cited. Exit interview conducted and a copy of the report was emailed to house manager Chantelle Browning.

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2022
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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