Facility Evaluation Report

Licensing Program Analyst, David Roman (LPA D. Roman) conducted an unannounced case management visit to check on the health and safety of residents in care as well as to interview a resident for an unrelated case. LPA D. Roman gained access to the facility, identified himself, and met with Facility Manager, Beatriz Rivas to discuss the purpose of today's visit. LPA D. Roman also met with Licensee, Irma Pineda via phone.

LPA D. Roman's visit consisted of briefly speaking with residents concerning their health and safety, touring the interior and exterior of the facility, and obtaining additional information about the residents care. Overall, the facility did not have any immediate health and/or safety violations and after speaking with residents did not receive any complaints about their health. The resident that LPA was to interview is out to dialysis services and is to return in the afternoon around 4:00pm. LPA is to return to interview the resident.

An exit interview was conducted with Facility Manager, Beatriz Rivas to which a copy of this report along with Licensee/Appeal Rights was provided to them whose signature below confirms receipt of this report and their rights.