Facility Evaluation Report

On 04/18/25, Licensing Program Analyst(s) Sommer Hayes and Kimberly Viarella arrived unannounced to open an initial 10-day complaint investigation visit and observed deficiencies to be addressed on a case management visit. Upon arrival, LPAs met with Caregiver (S1) and stated the purpose of the visit. The caregiver contacted the Administrator Sylvester Okoro (Administrator) regarding today’s visit. Administrator said he would be there in about an hour and a half and arrived 2 hours later.

The following deficiencies were observed when opening the complaint on 04/18/25. A walk through was conducted with S1 and LPAs observed that the non-ambulatory resident room with a capacity of 2, is now being used as a live-in staff room. This room was not cleared by Fire for staff use and is also the only bedroom that has immediate access to an exit and bathroom. An immediate civil penalty will be accessed in the amount of $500. Based on observation, file review and document review LPAs cited for a violation of fire clearance , 87202(a) . Please refer to report dated 4/18/2025 for regulation citation.

LPAs spoke to 3 care staff; (S1, S2, and S3) none were associated to this facility. LPAs cited for the following civil penalty. LPAs cited for this deficiency on the LIC 9099-D page and civil penalties were assessed on the LIC 421D in the amount of $1500.00, for background clearance, 87355(e)(3) . Please refer to report dated 4/18/2025 for regulation citation.

Due to technical difficulties LPAs were unable to print the 421IM and 421BG on 4/18/2025. This report is reflective of issuance of the Immediate Civil Penalties and have been cited on the 4/18/2025 complaint investigation report, which was documented in error of a Case Management visit..

A copy of this report was provided along with appeal rights, and an exit interview was conducted.