Facility Evaluation Report

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required 1-year annual inspection utilizing the inspection tool. LPA met with Administrator and explained the purpose of the visit.

LPA confirmed active Certificate via Community Care Licensing Division website Leonida Gaerlan #7033437740 effective April 22, 2024 to April 21, 2026.

LPA and Administrator conducted a tour of the facility to ensure the health and safety of residents in care. LPA observed sharps, toxins, and medications to be locked and secured. LPA observed facility to have two days of perishables and seven days of nonperishable foods at the facility. LPA observed nonskid mats present in showers. In areas toured no immediate health and safety violations was observed.

Additionally, LPA and Administrator discussed possible change of facility use. Administrator agreed to conduct meeting with assigned analyst when the time comes for change.

File review was conducted for residents in care. LPA observed that R1's LIC 602 stated R1 was ambulatory when R1 is nonambulatory. Additionally R2's LIC 602 indicated R2 does not have mild cognitive impairment nor dementia, but based on Administrator's statement, R2 is often forgetful. LPA completed file review for two residents and two staff files. Deficiencies cited. Please see LIC 809-D.

Technical Support Program was offered and accepted. LPA will submit referral.

Exit interview and a copy of report and appeal rights was provided.