Facility Evaluation Report

On 11/15/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted a case management visit at this facility. LPA met with administrator Karla Stein and explained the purpose of the visit was to gather information for a complaint in association with facility Sterling Senior Living 3 #198320308 complaint # 11-AS-20231109114136.

LPA interviewed the administrator and resident #1(R1) during this visit between 08:44 am am. LPA collected the following information associated with (R1):

ID/Emergency Information LIC 601 (dated: 11/05/23)

Appraisal/Needs and Services Plan LIC 625(dated: 11/07/23)

Physicians Report LIC 602 (dated:10/31/23)

Preplacement Appraisal Information LIC 603 (dated: 11/7/23)

Original Centrally Stored Medications LIC 622 (dated: October 2023)

Medication Administration Record (dated: November 2023)

Current Centrally Stored Medications LIC 622 (dated: November 2023)

An exit interview conducted with Karla Stein and a copy of the report was provided.