Facility Evaluation Report

Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced Case Management visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Resident Care Director (RCD), Anthony Bawalan.

Today’s visit was in response to the death of Resident #1 (R1), which licensee self reported. It was reported that R1 passed away on May 5, 2025 at the hospital.

LPA briefly toured the facility, performed a welfare check on residents in care, interviewed staff, and obtained copies of pertinent facility records. Additional information may be needed and further visits and or telephone calls. No deficiencies were observed or cited on this date.

An exit interview was conducted with Anthony Bawalan RCD, to whom a copy of this report, and the Licensee/Appeal Rights LIC 9058 (03/22) were provided to the Director, whose signature on this form confirms receipt of these documents.