Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced Case Management Incident visit and conduct a Health and Safety check. LPA met with Administrator Jennifer D Montgomery and explained the reason for the visit. The visit is in response to the death of resident (R1), who passed away on 1/29/2026.

During the visit, LPA reviewed R1's file and obtained copies of the following: ID/emergency Information, Admission Agreement, Physician's reports, Medication List, Care Plan and PACE documents. LPA requested a copy of R1’s death certificate when it is made available.

An exit interview was conducted, and a copy of this report was provided to Administrator Jennifer Montgomery.