Facility Evaluation Report

Licensing Program Analysts LPAs K.Kaur and S. Doucette conducted a Case Management to follow up on incidents that occurred on 11/21/21 . LPA was met by Staff Barbara Martin and discussed the purpose of the visit. LPAs and Licensee representative Anthony Barbato began the tour at the front entrance/office of the facility.

Upon entrance of the facility LPAs smelt a strong odor of urine.

Regarding incident facility contacted hospice nurse to notify of R1's medical condition. Facility did not submit incident report within the 7 days.

Deficiencies are being cited based on LPA's observation, interviews conducted, and record review in accordance with the CCR Title 22. See LIC 809D.

An exit interview was conducted with Licensee Representative Anthony Barbato and a copy of this report with Plans of Corrections and appeal rights was provided.