Facility Evaluation Report

Licensing Program Analyst Steve Chang conducted a POC case management visit to clear deficiencies cited on 09/11/2025, during the case management visit. LPA met with Administrator (ADM) Divina Fernandez. LPA explained the purpose of the visit to ADM.

The Facility was cited the following Type B deficiencies on 09/11/2025.

-87465(h)(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.

LPA toured the facility with ADM including living room, dining room, main kitchen, dining area kitchen, 6 resident rooms, 3 bathrooms and staff break room. No medications was observed scattered unattested. Medication room was observed locked. In service staff training log with staff signature were provided by ADM.

-87207 No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.

ADM discussed with LPA. ADM stated he/she stayed at the facility from 8:00AM to 11:00AM Monday to Friday and he/she and weekend as needed. ADM stated he/she will spend more time at the facility if needed. ADM stated he/she will provided the time sheet for staying at the facility.