Facility Evaluation Report

On 05/20/2026 at approximately 09:30 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted a Case Management visit during their initial complaint visit (Control# 31-AS-20260513105954) and the following deficiencies were observed.

Upon LPA’s visit. LPA requested pertinent documentation pertaining to the complaint visit they were investigating. When LPA requested Resident 1 (R1) file, the Administrator could not provide them with their file. When LPA requested the staff and resident roster, the Administrator could not provide LPA with the requested documentation. LPA observed the Administrator to print the forms for staff and resident roster and begin to fill them out. Additionally, LPA observed the Administrator and a staff member (S2) to look for R1’s file to no success. Per the Administrator they could not locate R1’s file. The Administrator was able to locate R1’s Physician’s Report and medication after reviewing their email correspondence but the file of R1 still remained missing.

No other immediate health and safety issues observed during the day of the visit. Exit interview was conducted, appeal rights given, and a copy of this report was provided to the Administrator.