Facility Evaluation Report

On 04/23/2026 at 11:35 AM, the Department arrived at the facility to conduct a case management visit related to Complaint Control # 11-AS-20260403094602. Upon arrival, the Department met with Administrator Robert Jakini and explained the purpose of the visit.

During today’s visit, the Department requested the following records such as Consent Forms, Admission Agreements, and LIC 602 Physician’s Reports for Residents R8 through R11 as well as conducted interviews with R8 - R11 between the hours of 11:55am - 12:41pm. The Department requested Power of Attorney (POA) documentation be submitted no later than the end of the day tomorrow on 04/23/2026.

These documents were collected to further assess Complaint Control # 11-AS-20260403094602.

Due to insufficient information available at this time, the case management incidents needs further investigation. An exit interview was conducted with Robert Jakini (Administrator) and copy of this report was provided.