Facility Evaluation Report

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Kona Home Adult Residential Facility for an unannounced case management visit. This visit is in response to an Special Incident Report called in to the Community Care Licensing Office on 8/3/23. LPA knocked on the door, was greeted by staff and granted entry. LPA was informed that the Administrator was not at the facility at the time. Staff contacted Administrator, Fausto Reyes and provided LPA the phone to speak to him. Administrator informed LPA that he has left for the day. Administrator left the Incident Report and Witness statements in a folder for LPA to collect. Administrator agreed to submit additional information to LPA on the following Monday, (8/7/23)

LPA completed a walk through of the facility. LPA informed that the resident census is 4. LPA observed no concerns for health and safety. No deficiencies were cited during this visit. An exit interview was conducted where this report (LIC 809) was discussed and provided to the Facility Representative, Carru Watson