Facility Evaluation Report

This Case management inspection is being conducted by Licensing Program Analyst (LPA) Abdoulaye Zerbo on 11-05-25 for the purpose of issuing a technical violation for deficiencies observed during the investigation into Complaint Control No. 18-AS-20251030102544. LPA met with Licensee Jane Mikenas and explained purpose of the visit.

During the facility visit, the Licensing Program Analyst (LPA) observed a hole approximately 13 cm in diameter in resident R2’s room. The licensee explained that R2 is a new resident and the damage occurred on October 26, 2025. According to the licensee, R2’s son requested that the damage remain untouched until their visit on November 8, 2025, to allow for a discussion with resident R2. The licensee committed to repairing the damage by November 14, 2025, and to submitting proof of correction. As a result, a technical violation will be issued.

An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to Licensee Jane Mikenas.