Facility Evaluation Report

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced Case Management Visit- deficiencies on 11/07/2025, stemming from incident report received on 10/16/2025. LPA was greeted by Office Manager Courtney Cortez and the purpose of the visit was explained. Director of Nursing Nicole Stinson joined shortly after.

On 10/30/25, LPA Gonzalez toured the facility’s medication room, obtained staff and client rosters, obtained copies of documents related to the incident, interviewed staff #1-3 (S1-S3) and attempted to interview residents #1-2(R1-R2). During today’s visit LPA interviewed S1 and S2, reviewed second floor med cart and reviewed R1’s medications.

According to LIC 624- Unusual Incident/Injury Report received on 10/16/2025, staff self reported that during a routine medication audit, it was discovered that R1 was not administered morning medications on 09/01/25.

A deficiency is noted on LIC 809D per Title 22 Regulations.

Exit interview was conducted with Director of Nursing Nicole Stinson and a copy of this report, LIC 809D, and appeal rights were provided.