Facility Evaluation Report

At 11:30am on 02/13/2026, Licensing Program Analyst (LPA) Jeffries arrived to the facility unannounced to conduct a case management visit based on a cross report SOC341 from the facility dated 02/12/2026, alleging that a Staff (S1) struck a resident (R1) in the arm. LPA met with Community Business Director, Delilah Kelly (CBD), announced who he is and the reason for the visit. CBD and LPA contacted Administrator, Nithi Narasappa by phone and informed her of the reason for the visit, and verified that CBD was authorized to sign this report.

LPA conducted interviews of staff and noted that the facility internal investigation is currently on going and S1 is currently on unpaid administrative leave pending completion of the internal investigation. LPA collected the current copies of the partial internal investigation that included pictures of R1. LPA additionally, requested documentation of S1 training and background clearance, Resident Appraisals Needs and Serviced Plan, Pre admissions appraisal, physicians report (LIC602) and family contact information. LPA also requested a facility staff contact information and a staff schedule for February 2026. LPA may request more documentation and conduct interviews as needed.

Exit interview, report read, and report provided.