Facility Evaluation Report

At approximately 9:45 AM Licensing Program Analyst (LPA) Stevenson arrived unannounced to conduct a Non-Compliance Conference (NCC) inspection and was greeted by caregiver Mark Kho who called Licensee/Administrator Anny Camerino to advise of today's inspection. Licensee Camerino arrived at approximately 10:15 AM to assist with today's inspection.

The facility was put on an NCC plan for 2 years ending 11/05/27 to bring the facility into compliance.

The purpose of today's inspection was to follow up on areas of prior concern in the operation of the facility operation identified by the department including, but not limited to:

Facility and facilities refrigerators were found to be clean and without odors.

At approximately 10:30 AM LPA reviewed four (4) of 4 resident records and found all 4 had required files. Resident (R1) moved in 8 days ago was missing an Appraisal Service and Needs and licensee will continue to fill out the form as they get to know the new resident.