Facility Evaluation Report

At approximately 10:45 AM, Licensing Program Analyst (LPA) Julie Florio, Licensing Program Manager (LPM), Bethany Moellers, LPM, Kimberly Mota, Regional Manager (RM), Carla Nuti-Martinez, Local Sheriff, Lake County Behavioral Health, Lake County Public Guardian, Adult Protective Services, Local Long Term Ombudsman, and potential placement professionals for residents in care arrived unannounced to deliver a temporary suspension order (TSO) and met with Licensee, Arlene Wing. Facility is a Residential Care Facility for the Elderly (RCFE) with five (5) clients in care. Facility is approved for 6 non-ambulatory residents and has a Hospice waiver for 2.

RM reviewed TSO packet with Licensee who conveyed understanding, Licensee was informed of APS contact information and services. Immediate exclusion for Individual 1 (I1) was provided to Licensee.

LPA delivered complaint investigation #21-AS-20260424101234 substantiated findings on all four allegations.

License obtained. All clients in care were relocated at the time TSO was issued, relocation sites provided.

Exit interview conducted with Arlene Wing.