Facility Evaluation Report

Licensing Program Analysts (LPAs) Kimberly Lyman and Kevin Saborit-Guasch conducted an unannounced case management visit to follow up on an incident report submitted to Community Care Licensing on 11/22/2021. LPAs were greeted and granted entry into the facility by Executive Director Daniel Lines and explained the reason for the visit.

Incident report dated 11/22/2021 indicated that Resident 1(R1) was discovered by a neighbor right outside the facility gate with the resident's dog. Authorities were notified and resident was redirected back into the facility. R1 was put on hourly checks as well as a caregiver outside the resident's room overnight.

During the visit, LPAs observed R1's room as well as the exit path. LPAs reviewed R1's physician report dated 10/12/2021 indicating R1 has a diagnosis of Mild Cognitive Impairment. R1 was moved by family into a memory care unit on 11/24/2021 with no adverse affects. Executive Director states R1 had exhibited behaviors and a gradual decline.

Exit interview conducted and a copy of this report was left at the facility.