Facility Evaluation Report

Licensing Program Analyst (LPA) Christian Gutierrez generated this Case Management - Deficiencies report in conjunction with complaint control 28-AS-20250626142210 pertaining to observations during record review. The purpose of the report was explained to Administrator.

During complaint investigation, LPA Gutierrez reviewed R1’s medication record and it was revealed that R1 only takes three medication for his seizures and not all medication prescribed. When LPA asked Administrator why R1 only takes three medications it was stated that R1 refuses other three. LPA spoke to Administrator, and it was revealed that no special incident reports (SIR) have been submitted to the department or to physician.

Based on observation, a citation is being issued. See LIC 809D.

An exit interview was conducted, and a copy of the report and appeal rights were issued.