Facility Evaluation Report

Licensing Program Analyst (LPA)Janet Ngallo conducted an unannounced visit to conduct a case management visit in response to an incident report received by the department on 02/24/2026 regarding Resident #1(R1). LPA identified herself and discussed the purpose of the visit with Administrator Nicole Voros Bugge.

The incident reported that on 02/22/2026, R1 asked Staff 1(S1) to observe an injury they had. S1 asked R1 how they were injured, and R1 could not give a specific date or time. The facility treated the injury with ice, and the following day on 02/23/2026, Staff 2 (S2) saw R1's injury, and took R1 to the hospital where they diagnosed R1 with a fracture and a sprain.

During today’s visit, LPA conducted interviews and obtained records. No deficiencies were cited at this time.

An exit interview was conducted with the Administrator and a copy of this report, and Licensee/Appeal Rights (LIC9058 01/16) were provided to the Administrator via email. Their signature on this report confirms receipt of these documents.