Facility Evaluation Report

On 04/20/2023 at 09:45 AM, Licensing Program Analyst (LPA) Melody Brown met with Direct Service Professional II Felicia Masters to initiate a Case Management Visit. The investigation consisted of interviews and a review of pertinent documentation.

During today's visit, LPA Brown toured the facility. Residents in care were present during the visit. LPA Brown observed no health and/or safety hazards inside the facility. LPA Brown inspected the outside perimeter of the facility and observed no health and/or safety hazards. LPA Brown observed sufficient staff present at the facility to provide care. LPA Brown inspected facility food supplies and observed more than three (3) days’ supply of perishable and more than seven (7) days’ supply of non-perishable food. The needs of the residents in care appear to be met during this inspection.

During the facility visit last 04/20/2023 at 09:45 AM, LPA Brown reviewed documents and interviewed staffs and observed that Staff #3 (S3), Staff # 7 (S7) and Staff # 8 (S8) have a current criminal background clearance but S3, S7 and S8 are not currently associated to the facility. Staff interviews and records review indicated S3 had been working at the facility since 03/11/2022, S7 started working at the facility last 03/22/2023 but interviews and records review revealed S7 worked two (2) days at the facility last 03/31/2023 and 04/18/2023 and S8 had been working at the facility last 10/27/2022 and interview and records review indicated that S8 worked at the facility last 11/18/2022, 03/03/2023, 03/10/2023, 04/07/2023 and 04/17/2023. LPA Brown informed DSP II Masters that deficiency will be issued as this pose potential health, safety and personal rights risks to residents in care.

Civil Penalty was assessed with the amount of $500.00 for S3 and S8 and $200 for S7 during the Facility Visit for failure to transfer S3, S8 and S7 Criminal Background Clearance to the facility.

An exit interview was conducted where this report (LIC809), LIC809D, LIC421BG and Appeal Rights were discussed and provided to Direct Service Professional II Felicia Masters.