Facility Evaluation Report

Unannounced case management visit made out to this facility on 03/19/2025 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility staff person, Erica Lopez, who was briefly interviewed at this time. This LPA requested that the staff person go ahead and contact the facility designated Administrator, Bokime Etim, who spoke with this LPA over the phone.

The purpose of this case management visit was to follow up and obtain additional forms and documents related to residents, R1 and R2, at this time.

The following request was made for this facility to provide the forms and documents as stated below:

Any, and all, LIC 624s related to R1 and R2 since 01/01/2025

Any, and all, facility progress notes related to R1 and R2

There were no deficiencies observed or cited during today's case management visit since this LPA's sole purpose was to retrieve additional information related to recent incidents that took place in regards to resident R1 and R2.