Facility Evaluation Report

On 6/9/2025, Licensing Program Analysts (LPAs) Triel Ellen Lindstrom and Arielle Pascua arrived announced for a case management visit to tour the Memory Care unit. The facility has requested an increase in their capacity from five to fourteen bedridden residents. The Department has received the facility's updated Plan of Operations, which incorporates the required language about dementia care, a signed LIC 200, a completed STD 850, and a new facility sketch that designates bedridden rooms. The LPAs met with Designated Facility Administrator (DFA) Lacy Vincent, who gave them a tour of the new Memory Care unit.

On the tour of the Memory Care unit, the LPAs viewed the common areas, two resident bedrooms, two laundry rooms, a storage area, the kitchenette, the reception area, two interior courtyards, and an enclosed outside paved walkway and garden. The current capacity of the unit is 22 residents. The unit is clean and the rooms contain the required furnishings. The LPAs observed residents gathered around a large table with the Activity Director and her assistant doing a painting project.

The outdoor area with a walkway is located in the front of the building between it and the parking lot. It is enclosed with a tall metal perimeter fence. The gate leading out of this area is currently unlocked. Because of this, residents are accompanied one-on-one with a caregiver when in this area. A technician has been scheduled to install a delayed egress on the gate in mid-June.

The new Memory Care unit contains six rooms that have been cleared for bedridden residents. These six rooms are Rooms # 501, 504, 505, 520, 524, and 525. These rooms are identical to every other room in the unit. The rooms designated as bedridden rooms on the new facility sketch are all located near the corners of hallways. DFA Vincent stated that this location will make it easier for staff to evacuate residents in the case of