Facility Evaluation Report

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced on 8/3/2026 at approximately 10:30am to conduct a Case Management visit. LPA met with Mirafe and stated the purpose of the visit.

LPA requested information for R1. R1 has had a change in condition and as a result R1 requires total assistance with all ADL. The Department has reviewed R1's health-related conditions, and has determine that R1 may not be appropriately placed in the facility. Although R1's health related needs are being met. The Department has informed the licensee that the client's health related condition requires review and has requested documentation that the licensee shall submit to the Department.

(1) Documentation includes, but is not limited to, the following:

(A) Restricted Health Condition Care Plan, if applicable. or an updated LIC 602

(physician's report) for ambulatory status.

(C) Copies of prescriptions for medical services and/or medical equipment.