Facility Evaluation Report

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry by Angelica Oosting. LPA began inspection with introduction, visit purpose and provided the facility with LPA identification and business card.

Resident record review began- Six (6) records were reviewed. LPA reviewed for admission agreement-1 amended, medical assessment and TB test results, consent forms-missing, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records-6 missing, safeguard for personal property/valuables, and personal rights notification. This facility is not meeting documentation requirements. TSP will be requested and mandated for the facility.

Employee records review began- Four (4) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance-1 does not have, 1 is not associated, personnel/job application, health screening-2 missing and TB test results, criminal record statement, training verification-(4) requested and was not able to be viewed for 2026, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current 03/12/2027. Corporation or LLC is active and in good standing. TSP will be requested and mandatory for the facility.