Facility Evaluation Report

On 10/23/2025, Licensing Program Analyst (LPA) Armando Perez made an unannounced case management incident visit. The LPA was granted entry by staff to conduct the visit and met with administrator, Rolanda Henderson. The LPA informed the Administrator of the purpose for the visit. On 10/22/25 the department received a death report, reporting that Resident #1 (R1) passed away on 10/21/25.

During the visit, LPA conducted an interview with Administrator Rolanda Henderson, staff and clients. LPA obtained copies of pertinent records both physically as well as electronically. Per Administrator, the official death certificate has not been issued at this time, nor has a preliminary cause of death been provided. LPA advised Administrator to send a copy of the death certificate to the Department as soon as it is available. Additionally, there were no health or safety concerns, observed during today's visit.

An exit interview was conducted, where a copy of this report, and LIC811- Confidential Names list was reviewed and provided to facility representative.