Facility Evaluation Report

Unannounced case management visit made out to this facility on 06/13/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility designated Administrator, Nicole Ell, who was briefly interviewed at this time.

Current census was 4 residents, of which (3) residents, were out of this facility attending their respectable day programs at this time. It was learned that (1) resident was out of this facility at the hospital at this time.

It was learned that there weren't any residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (6) residents under the care of hospice at any given time.

It was learned that this facility does have a program to be able to accept and retain dementia residents at any given time. It was learned that there were (2) residents diagnosed with dementia at this time.

It was learned that there weren't any residents receiving services through home health at this time.

It was learned that there weren't any residents deemed to be bedridden at this time.

The purpose of this visit was to follow up on a reported incident for a resident, R1, at this time.

A review of the file for R1 was conducted at this time.

A review of the care plan for R1 was conducted and was observed to have been completed on 09/16/2024 upon admission.

There were no deficiencies observed or cited during today's case management visit at this time.