Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced case management visit to follow up on an Incident Report received by the Department on 06/23/2026. LPA Rai met with Administrator, Julius Ervin Javier and stated the purpose of today's visit. LPA Rai observed 2 staff and 3 residents at the facility, 3 residents are attending day program.

On 06/23/2026, the Department received an Incident Report for resident (R1) who was taken to urgent care on 06/22/2026 for an assessment on skin redness noted on the lower back area. Per Report, R1 was transferred to the Emergency Room Department and was diagnosed with Stage 1 Pressure Injury. R1's After Visit Summary document dated 6/22/2026 was attached to the Incident Report which stated R1 was diagnosed with Stage 1 Pressure Ulcer.

During today's visit, LPA Rai interviewed 2 staff (S1-S2) and ADM. Three out of three staff stated they noticed R1's skin was red with skin breakage which was a change of condition. They stated R1 has had skin redness in the past but it was resolve on its own. On 06/23/2026, the staff observed the skin redness and skin breakage and took R1 to urgent care and then Emergency Room. They stated R1 was discharged with Stage 1 Pressure injury and they were given a medicated patch to place on R1's skin. ADM stated they created the updated care plan and trained staff on monitoring R1's skin and reporting to R1's primary care physician on any changes to the skin.