Facility Evaluation Report

Licensing Program Analysts (LPAs) Cheyenne Ratajczak and Cassandra Mikkelson arrived at the facility unannounced to conduct a case management visit. LPAs met with Administrator Leriza Arambulo and explained the purpose of the visit. The purpose of this inspection is to follow-up on issues that were discussed in the Non- compliance meeting that took place on 11/18/2024.

The facility is currently licensed for (6) non-ambulatory, hospice waiver of six (6). During today's visit, there are six (6) residents and two (2) resident receiving hospice services.

LPA compared medications to those being given for six (6) resident and found discrepancies. LPAs observed facility writing on prescription labels for multiple residents. Additionally, facility is pre-pouring five (5) days in advanced.

As a result of today's inspection, deficiencies cited. Please see LIC809D

Exit interview conducted and a copy of the report and appeal rights was left at the facility.