Facility Evaluation Report

LPA D. Roman conducted an unannounced case management visit to follow up the facilities unusual incident reports (UIR) pertinent to a residents relocation wants. LPA D. Roman identified, discussed the purpose of the visit, and was provided entry into the facility by DSP staff. LPA D. Roman later met with, Program Administrator, Miriam Silva via phone. Merakey Program Administrator, Jennifer Melcher was contacted as PA, Miriam Silva was out of the facility.

Durin g today's visit, LPA D. Roman along with facility staff conducted a tour of the interior and exterior of the home. LPA D. Roman reviewed resident files and interviewed staff pertinent to the UIR. The resident's record review illustrated that the resident voluntarily exited the facility on 07/02/2025. The resident is not conserved and was advised not to leave the facility. However, the resident signed documentation identifying their insistence to leave the facility against clinical team advice.

This report was discuss with Jennifer Melcher. A copy of this report, along with Licensee/Appeal Rights, was provided to them at the conclusion of the visit. Their signature on this form acknowledges the receipt of this report and their rights.