Facility Evaluation Report

On 05/05/2023 at 1:30 PM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct a Required Annual Inspection. Upon entry, LPA stated the purpose of the visit with Staff Member Anabel Adviento.

Staff Member Marie Regacho toured the facility inside and outside with the LPA and during the inspection, the LPA spoke with Licensee Arsenia Lising by phone on 2 occasions. The LPA interviewed 2 residents and 1 staff member, and reviewed a portion of the facility, personnel, and resident records.

During this inspection, 3 A-Type and 6 B-Type citations were issued (refer to LIC809-D for details). One Civil Penalty was issued (refer to LIC421FC for details). 3 Technical Violations issued for violations of the regulations that do not pose a risk to the health and safety of persons in care.

Additional visit required to complete the Required Annual Inspection for this facility.

Updated copies of the following documents have been requested. They are to be submitted to CCL on or before 05/12/2023:

· Evidence of Current Liability Insurance

Exit interview conducted and a copy of this report provided via email.