Facility Evaluation Report

On 08/08/2023, Licensing Program Analysts (LPAs) Arielle Pascua and Christina Valerio arrived unannounced to this facility to conduct a case management visit. LPAs were greeted by Staff member (SM), Norma Borges and explained the purpose of the visit. LPA Pascua asked that SM Borges call and informed Facility Designated Administrator (FDA), Julian Hawes, that CCL was present at the facility. It was learned at this time that FDA Hawes was unable to come to the facility but LPA was able to speak with FDA Hawes on the phone. LPAs continued the visit with SM Borges.

Current Census was 4. 1 out 4 residents were out at their respective day program. A brief interview with SM Norma Borges was conducted.

The purpose of this case management visit was to follow up on the facility not having a current qualified administrator in place. The current Administrator, Julian Hawes, administrator certificate expired on 07/29/2023. LPA Pascua asked that Administrator Hawes provide documentation to show that he has re-certified his administrator certificate before the expiration date. LPA Pascua was informed that the Administrator has appointed a new administrator in his place. LPA Pascua asked that the following documentation be sent to the LPA's email by End of Business, 08/09/2023.

A letter from the licensee and/or Board appointing the individual as the Administrator

Any documentation that meets the education and/or experience requirements, if applicable

Licensee was informed that failure to provide documentation may result in deficiencies.

No deficiencies cited during this case management visit. An exit interview was conducted and a copy of this report was provided to the facility at the end of this visit. A copy was sent via email and an electronic email read receipt confirms receiving these documents