Facility Evaluation Report

On 9/7/23, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct a case management visit. LPA met with facility representative Steve Sarine and explained the purpose of the visit.

The purpose of the case management visit is to follow up on deficiencies found during a complaint investigation conducted by the Department for complaint dated 9/19/2022, control number: 27-AS-20220919221525

The following deficiencies were identified during the complaint investigation:

- Personal Rights - Staff blocked resident (R1’s) doorway with a couch to prevent resident from leaving. This incident was witnessed by facility staff.

- Administrator Qualifications - The designated administrator (A1) did not act in their capacity as the Administrator. A1 told the Department that he was hired as a consultant and was working in the facility only until designated administrator (A2) could obtain their Administrator certificate. On 8/4/22, during a non-compliance meeting, A1 was designated as the facility administrator.

- Basic Services - Facility did not provide adequate supervision which resulted in R1 sustaining multiple injuries from falls. During the investigation, (A1) stated that the private care agency will provide all the care and supervision to the resident, however per Department guidelines, private agencies are only allowed to provide companion services not care and supervision.