Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Case Management Deficiency visit in conjunction with a complaint visit, 28-AS-20230131141908. This report is being generated to address the deficiency observed.

During the course of the complaint investigation, Investigative branch and CCL found out that the facility failed to meet the reporting requirements in which facility did not submit an Unusual Incident/Injury Report concerning R1' fall on 10/14/2022.

Deficiency is cited on LIC 809D. An exit interview was conducted, and a copy of this report was provided to Diana Bautista-Martinez, Executive Director along with the Appeals Rights.