Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced case management visit - other to ensure the health and safety of the residents in care. Upon arrival at approx 09:40 a.m., LPA met with staff and explained the reason for the visit. Licensee was contacted and stated they will be at the facility soon.

At approx 10:02 a.m. LPA conducted physical plant, interviewed staff, residents and reviewed and obtained copies of facility documents. LPA observed a sufficient supply of perishable and non-perishable food properly stored at this time. LPA and staff inspected produce that was stored in fridge drawers. LPA observed produce to appear fresh and free of any signs of mold at this time. Interviews with residents revealed they have been provided with sufficient meals and snacks since LPA's last visit on 10/27/2025 and residents did not express any concerns at this time.

On 10/16/2025, during a case management visit conducted from 9:30 a.m. to 4:00 p.m., LPA observed Staff #1 (S1) present inside the facility. At that time, S1 was not associated. S1 was instructed to leave the facility.Today the LPA received information indicating that S1 continued to provide services to residents in care. During interviews with Resident #1 (R1) and Resident #2 (R2), both residents stated that they have observed S1 on multiple evenings, sleeping in Bedroom #1, since the LPA’s visit on 10/16/2025

On 10/28/2025, the Licensee provided LPA with the following documents to update facility administrator:

Administrator Certificate - exp 02/05/2027, LIC 308 ,LIC 501, LIC 503, Board Resolution , Criminal Record Statement, Employee rights. LPA requested licensee to update the following LIC 308, LIC 501 and LIC 503. Licensee stated they are waiting on the new administrator to complete and will send to LPA as soon as they receive them.