Facility Evaluation Report

Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced Case Management - Incident visit. LPA identified herself and was granted entry into the facility by Aileen Spence Associate Executive Director, with whom LPA met and discussed the purpose of the visit.

Today's visit was initiated in response to an LIC624 Incident and SOC341 Report of Suspected Dependent Adult/Elder Abuse, which was received by Community Care Licensing (CCL) on March 21, 2025, in which licensee self reported a resident to resident altercation.

LPA briefly toured the facility, performed a welfare check on residents in care, interviewed staff, and obtained copies of pertinent facility records. No immediate health or safety risks were observed. Additional case management will be provided for this incident, including subsequent visits and staff interviews, as needed.

An exit interview was conducted, and a copy of this report and Licensee Rights LIC 9058 (03/22) were left with the Associate Executive Director, whose signature on this form confirms receipt of these documents.