Facility Evaluation Report

Licensing Program Analyst (LPA) Amy Goldenberg is conducting a case management visit for the purpose of a health and safety check. LPA met with Program Manager, Kelly Larsen and Quality Assurance, Jesus Salazar. LPA explained the nature of the visit in relation to an incident reported received 11/10/2022 self reporting personal rights violation of R1 by employee S1.

During this visit LPA conducted a tour of the facility and verified that the facility health and safety mandates are being met. LPA observed that residents bedrooms are safe and furnished comfortably, all medications, chemicals, and dangerous equipment is locked inaccessible to residents in care. PPE, emergency food supply, and daily available food is adequately stocked. LPA observed residents in care engaged in group activities and do not appear to be in any immediate danger.

LPA requested and was provided copies of employee and resident records for resident R1 and employee S1. LPA advised the facility representatives that additional inquires into this incident will be required prior to closure of review of this incident.

This report was reviewed with and a copy was provided to the facility representative.