Facility Evaluation Report

Licensing Program Analysts (LPA) Tyler Reyes conducted the required annual inspection. LPA met with Administrator Crystene Char and discussed the purpose of today’s visit.

This facility is approved for (81) ambulatory and (119) non-ambulatory residents (of which 10 may be bedridden). This facility has an approved hospice waiver for (15) residents. The following bedrooms are approved for bedridden residents: #206,207,208,209,210,106,107,108,109 and 110.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Facility has an Infection Control Plan in place.

Operational Requirements: This facility is approved for (81) ambulatory and (119) non-ambulatory residents (of which 10 may be bedridden). This facility has an approved hospice waiver for (15) residents. The following bedrooms are approved for bedridden residents: #206,207,208,209,210,106,107,108,109 and 110.

Staffing : Facility is adhering to staffing requirements.

Due to time constraints, LPA will return at a later date to complete all (12) CARE Tool domains. Exit interview conducted with Administrator Crystene Char and a copy of this report was provided.