Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek made an unannounced case management visit regarding a self-reported incident on the relocation of 5 clients from Lightfully – Sunrise – License #198320254 to Lightfully – Halo License #565850302 due to mandatory evacuation orders from Fire Advisory. LPA initially met with facility staff and explained the reason for today’s visit. LPA was informed that the Lightfully – Halo location does not have any clients currently, therefore only clients and staff from Lightfully – Sunrise are currently present at the facility.

During the visit, LPA Dulek along with facility staff, conducted a health and safety check and no concerns were observed. Clinical Director/Administrator Jane Alt from Lightfully – Sunrise was initially in session but joined the visit shortly after the facility tour. LPA also met with Primary Therapist Evan Sahn during the visit. LPA reviewed resident and staff rosters for the facility.

Per interview with the facility management, 5 clients have been relocated to Lightfully – Halo. The facility has sufficient beds, hygiene supplies, bedding, linens, and everyone has a designated room. The facility contains 3 (three) shared client rooms and 4 (four) restrooms. The facility has a sufficient 2-day perishable and 7-day non-perishable food supplies. Facility Management noted that there was a Public Safety Power Shutoff (PSPS) at this location for about a day and a half. Power was restored on 01/09/2025 in the afternoon. During the PSPS, the facility utilized food delivery services and have since replaced perishable foods that may have been spoiled due to the power shut off. Medications of the Lightfully – Sunrise clients have been transferred to Lightfully – Halo and are stored in the locked medication cart in the locked nursing office. All MARs and client files are stored electronically; therefore staff have access to Lightfully – Sunrise documents at this location. All client personal belongings have been relocated to this location. All Lightfully – Sunrise clients are fully ambulatory and use no assistive devices.

Facility Management stated they were able to fill medications using a local pharmacy during the time of relocation. The facility also has licensed LVN on staff to care for clients’ health care needs. At this time,