Facility Evaluation Report

On 10/24/2025 at 8:35am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced Case Management - Incident visit at this facility. LPA met with Robert Jakini (Administrator) and explained the purpose of the visit to conduct a health and safety check to follow up on a reported incident to the department on October 22, 2025 in regarding personal rights.

The incident report is in regards to personal right for Resident 2 (R2).

Between the hours of 8:45am - 8:50am, LPA conducted a tour of the Resident 1 (R1) and Resident (R2) shared bedroom with Staff 1 (S1).

LPA requested and obtained LIC 602 Physician's Report for Residential Care Facility for the Elderly for both Resident (R1) and Resident (R2).

Due to insufficient time LPA has decided additional time is needed to complete the investigation.

Exit interview conducted with Robert Jakini (Administrator) and a copy of this report was provided.