Facility Evaluation Report

On October 2, 2024 at 9:40am Licensing Program Analyst (LPA) Zina Brown conducted an unannounced health and safety check to follow up on a incident that occurred on October 20, 2024

During today visit we met with Jemimah Mejia, Administrator and explained the purpose of the visit.

During today's visit, LPA conducted a tour of the facility of the common areas such as shower rooms, women's restroom, men restroom, dining areas, kitchen and activity room.

LPA also reviewed and collect documents such as LIC 500: Personnel Report

Medication Administration Record from August 1, 2024 - October 27,2024 (for resident #1)

LIC 602: Physician's Report for Community Care Facilities

LIC 603: Preplacement Appraisal Information

Due to insufficient information available at this time a further investigation is needed.

A exit interview was conducted with Jemimah Mejia, and a copy of this report was provided.