Facility Evaluation Report

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Case Management Annual Continuation visit to the facility. Upon arrival, LPA met with med-tech who granted access to the facility. Later Licensee/Administrator joined and explained the purpose of the visit. This visit was conducted to complete Required 1 year inspection initiated on 09/26/2025.

During this visit at 9:55a.m., LPA and Med-Tech conducted a tour of the facility, including both interior and exterior areas to ensure no health and safety hazards were observed at the time of inspection. At approximately 10:30a.m., LPA recorded ten (10) residents’ interviews previously conducted during initial visit. At about 12:35p.m. LPA reviewed five (5) out of one hundred and two (102) residents records and they were complete at the time of this visit. LPA also reviewed those five (5) residents’ medication and MAR’s records. Medications are in a centrally stored and locked medication room in Wellness room including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation forms. First-aid kits have all proper items and were observed to be stored in the Wellness room. LPA reviewed six (6) staff files, and they had criminal record clearance and Cardiopulmonary Resuscitation (CPR) certificate at the time of this visit. All required documents were appropriately signed and dated.

No deficiencies were observed during today’s visit. The facility appears to be operating within Title 22 regulations. All required postings were visible and current, including the facility license, complaint poster, personal rights, and emergency disaster plan.

No immediate health or safety hazard were observed. An exit interview was conducted. A copy of this report was issued.