Facility Evaluation Report

Licensing Program Analyst (LPA) Mariana Agban conducted a case management visit to note deficiency found during a complaint visit conducted on 10/16/25. On 10/16/25 LPA Agban conducted an investigation for complaint # 31-AS-20250422083808. During the course of the investigation, it was revealed that Resident #1 (R1) had a behavior which let to hoarding in their bedroom. Per document review there were no records that indicate that facility staff had assisted R1 with obtaining assistance with the behavior. Furthermore, the licensee did not ensure that changes in R1’s mental condition were documented and reported to the resident’s physician and responsible party, as required.

Deficiency was noted on LIC809D per Title 22 Regulations.

An exit interview was conducted and a copy of this report, LIC809D, and appeal rights were provided to the facility representative.