Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management Visit and met with Racheal Mosly .

The purpose of the visit was to follow up with the facility for failing to report two incidents in which resident R1 was taken to the hospital.

LPA Marrufo obtained copies of R1’s After visit Summary from hospital visits on 05/02/2025 and 05/07/2025. The After Visit Summary from 05/02/2025 states the issue addressed during the visit was “easy bruising.” The After Visit Summary form 05/07/2025 states the issue addressed during the visit was "multiple open wounds."

However, there are no incident reports sent from the facility for those two hospital visits.

An Advisory Note was issued. See LIC9102 page for more information.

This report was reviewed with Racheal Mosly and a copy of this report was provided.