Facility Evaluation Report

Licensing Program Analyst (LPA) conducted a case management visit, on 3/30.2026 at approximately 3:32pm, and met with Administrator Douglas Blake.

This case management is addressing deficiencies identified by the LPA during a complaint investigation conducted earlier today, 3/30/26.

There is no exception or waiver to the fire clearance approval, and the facility is to maintain compliance with the fire clearance.Per record reviews, R1 had a medical assessment on 2/22/23 that identified a change in condition; R1 was marked as non-ambulatory, per physical condition, and was residing on the 3rd floor which is fire cleared for "ambulatory only".

This is a deficiency, and will be cited, 87202(a) Fire Clearance -All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal, see LIC809D.

An immediate civil penalty will be assessed in the amount of $500, see LIC421IM.