Facility Evaluation Report

On 04/21/26, Licensing Program Analyst (LPA) M. Yang conducted an unannounced case management

inspection regarding incident report received from the facility. LPA met with Administrator Gladys Hernandez.

The purpose of the today's visit is to follow up on the incident report that was submitted to department on

04/12/26 where C1 had ingested an electrical prong. C1 was sent to the hospital immediately after incident occurred.

The information provided will be reviewed; a follow up case management will be conducted if necessary.

An exit interview was conducted. A copy of this report was provided to Administrator, whose signature on this form confirms receipt of this report.