Facility Evaluation Report

On 8/27/2025, at 11:56 PM, Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced case management health and safety visit because of resident-on-resident physical altercation. LPA Allen was greeted by the Administrator Clifton Douyon, who was informed of the purpose of the visit.

At the time of the visit LPA Allen requested and received the following documents for resident 1(R1). The assessment summary dated 3/20/2025 which is the original assessment upon R1's arrival to the facility.

Resident 2 (R2) Assessment Summary dated 2/5/2025 and the reassessment dated 4/1/2025 and LIC624 with a statement of their adjusted care plan.

Clifton has stated R1 and R2 have been separated into different rooms, the residents’ responsible parties were notified of the incident and changes to avoid any future altercations. Staff members have and will continue to observe R2 behaviors and will make note of any changes of conditions. LPA also observed residents separate rooms and observed both residents and there were no health or safety concerns.

An exit interview was conducted, and this report was provided to Administrator Clifton Douyon at the conclusion of the visit.