Facility Evaluation Report

In conjunction to complaint control #31-AS-20250429144827 , Licensing Program Analyst (LPA) Evelin Rios met with licensee representative, Josephine Miranda. LPA explained the purpose of the visit.

This visit is to notify the licensee representative of the facility’s ongoing concerns related to regulatory compliance under Title 22 . The purpose of the visit was to address multiple non-compliance issues related to the facility’s hospice waiver, as referenced in complaint #31-AS-20240125095336 and a case management visit conducted on 08/11/2025, as well as additional deficiencies observed during recent visits. LPA informed the licensee that, due to the continued pattern of non compliance, the Department is seeking additional actions against the licensee.

During today’s visit LPA requested a copy of the current Register of Facility Residents (LIC9020), Personnel Report (LIC500) and administrator’s file. According to Josephine she is responsible for the day to day operations of the facility and the administrator will come by to check on the residents, the care being provided, and medications.

LPA contacted the administrator at 3:05 p.m., LPA was dialing the telephone number on file. The number would not connect. Josephine provided LPA a different telephone number. LPA dialed the number and left a voicemail for a return call. LPA has been unsuccessful at reaching current administrator, Divina Heidelberg.

Exit interview conducted. Copy of this report provided.