Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced Case Management- Incident visit in response to resident#1 (R1) Incident Report, dated 08/21/24. The facility has a capacity of 90 residents and licensed to serve elderly residents age 60 and above. The facility is approved for fifty-six (56) non-ambulatory residents. LPA explained the purpose of today's visit to Irina Sarkisyan, Community Business Director who assisted with this visit.

During today's visit LPA toured the facility, interviewed Administrator, staff, resident#1 (R1) and reviewed R1's file. The incident report stated R1 reported that staff took R1 out to the courtyard at 7am for 10 mins. R1 was upset and stated staff hit R1. LPA interviewed Administrator/staff revealed that the facility investigated this incident and the finding was unfound. Per interview of R1, resident seem unable to recall the incident. Police came and found it unfound. Case#24-18510. LPA did not observe nor identify signs of neglect, abuse or other immediate health and safety threats.

LPA obtained copies of the following documents:

· R1’s Identification/Emergency Contact Information (facesheet)

No deficiencies were observed and cited during this visit. Exit interview held and a copy of the report was provided.