Facility Evaluation Report

Licensing Program Analysts (LPAs) Janira Arreola, Seo Jeon, and Abdoulaye Zerbo conducted an unannounced visit in order to conduct a case management and follow up of visit conducted on 07/23/2026. LPAs met with Medication Technician, Ligaya Carter, who was informed of the purpose of the visit. LPA Arreola conducted interviews, records review, and observations.

The Department observed Resident #1 (R1) and Resident #2 (R2) were listed to be self responsible on their Face Sheet and Emergency Information Forms. LPA investigated R1 and R2’s ability to make medical decisions.

R1 was interviewed at the time of the visit which revealed R1 is alert and oriented and indicated being able to make their own medical decisions. R1’s LIC602 Physician’s Report revealed R1 has a diagnosis of Mild Cognitive Impairment with no disorientation, and is able to communicate their care needs. Interview with (2) staff revealed R1 is alert and oriented, is able to communicate their care needs, and is able to make their own medical decisions. Therefore, based on interviews and records review no concerns were found on R1’s ability to make their own medical decisions at this time.

R2 no longer resides at the facility and was unable to be interviewed. R2’s Face Sheet and Emergency Information Form listed R2 had a conservator. Interview with R2’s conservator revealed that R2 has been conserved since December of 2025 and was deemed by a medical professional to be able to make their own medical decisions and retained these powers.