Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to the facility to verify clearance of Plan of Correction from visit on 3/21/2025. LPA Rico met with Administrator Brandon Marquez and was granted entry to the facility.

The following deficiencies were not cleared during the time of the visit:

The Licensee was cited on 3/21/2025 for 87458(a) Medical Assessment . During today's visit, based on record review, observation and interview, LPA Rico observed that the Licensee did not have send LPA R1 medical assessment. The Plan of Correction was to send LPA Rico R1 Medical Assessment. Therefore, the POC was not cleared at the time of the visit. Civil penalties will be assessed in the amount of $100 per day for four (4) days.

The following deficiencies were cleared during the time of the visit.

In addition, on 3/21/2025 the facility was for 874655(c)(3) Incidental Medical and Dental Care Services for not documenting PRN medication properly that included the date, time and resident response. LPA Rico observed the Administrator had created an in-service training for staff. The Plan Correction was cleared and a copy of clearance letter was provided to Administrator.

An exit interview was conducted and this report, LIC809 along with Civil Penalty Assessment pages, and Appeal Rights were reviewed and provided to Administrator Brandon Marquez .