Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Case Management Visit-Incident on 09/11/2025, stemming from an incident report received on 08/22/2025. LPA was greeted by Alternate Administrator- Mariano Prieto and explained the purpose of the visit.

On 08/22/2025, LPA Ramirez received an Unusual Incident/Injury Report (LIC 624) and Report of Suspected Dependent Adult/Elder Abuse (SOC 341), regarding the alleged verbal abuse of Clienr#1 (C1) by Staff#1 (S1) on 08/19/2025 at 11pm. Review of these documents revealed S1 was heard by S2 being verbally harsh and disrespectful to C1 while S1 was assisting C1 with toileting. On 08/20/2025, S2 immediately reported the incident to the facility Administrator Russell Johnsrud. S1 was placed on leave pending an internal investigation. After an internal investigation, S1 was terminated on 09/02/2025.

Records reviewed and interviews conducted by LPA Ramirez determined the facility staff immediately reported the incident, the facility administrator immediately placed S1 on leave pending an investigation, and after an internal investigation S1 was terminated, therefore no deficiency was cited during this visit. Alternate Administrator Prieto advised LPA staff retraining will be conducted on Mandated Reporting Policy/ Corrective Action for failure to comply with Mandated Reporting Party by 09/25/25 and he will email LPA Ramirez a copy of completed training.

Exit interview was conducted and a copy of this report was provided.