Facility Evaluation Report

Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced case management visit to follow-up on an incident. LPA was greeted by, identified herself to, and explained the purpose of the visit to Administrator Elizabeth Reyes.

The facility self reported an incident regarding Resident 1 (R1) (See LIC811 Confidential Names List) on September 9, 2021.

During the visit, LPA reviewed and obtained copies of resident records. At this time the incident requires further investigation. No deficiencies were cited during today's visit.

An exit interview was conducted with Administrator Elizabeth Reyes, to whom a copy of this report and the Licensee's Rights (LIC9058 01/16) were provided via electronic mail.