Facility Evaluation Report

On 11/14/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Case Management – Incident visit to the facility listed above. LPA met with Licensee, Tina Cinco, and the purpose of today’s visit was explained. LPA was granted entry into the facility.

On 11/09/2025, the Regional Office received an Unusual Incident/Injury Report (SIR) regarding an incident that occurred between Residents R1 and R2 on 11/09/2025. The report stated when Staff S2 entered the resident’s room, R1 was observed with blood on their face and pillow. Staff S2 immediately called 911 and paramedic arrived, treated R1 and suggested to call the police department. No incident was observed between Residents R1 and R2. R2's family decided to move them out of the facility.

During today’s visit, LPA conducted a Health and Safety Check on all residents, interviewed Staff S1 and S2, interviewed Residents R1, R3-R6, and reviewed R2’s Physician’s Report and Appraisal/Needs and Service Plan.

During interviews with Residents R1, R3-R6, were asked if they felt safe living in this facility, three (3) out of five (5) stated they feel safe living at the facility. Two (2) residents were unable to answer due to conditions. LPA was able to interview Resident R4’s responsible party (W1), who stated yes, they feel their family is safe living in the facility.

During today’s visit, LPA did not observe or cite any deficiencies.

LPA did not observe any immediate Health or Safety Concerns.

An exit interview was conducted with Licensee, Tina Cinco, and a copy of this report was provided.