1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 | On 03/11/2025 in conjunction to complaint control #31-AS-20250124110820, Licensing Program Analyst (LPA) Evelin Rios conducted a Case Management Deficiencies Visit. LPA met with the administrator and explained the reason for the visit.
On 01/28/2025 at 10:24 a.m., LPA conducted a physical plant tour to ensure the health and safety of the residents in care. During this tour, at approximately 10:27 a.m., LPA interviewed resident #1 (R1). At approximately 10:30 a.m., LPA conducted an interview with the administrator. At 11:00 a.m., LPA reviewed the facility's Licensing Information System (LIC) facility profile, Guardian Background Check System, employee roster, and fire inspection with facility sketch. LPA's review of the approved fire inspection (LIC 850) from 10/12/17 and facility sketch revealed the facility has a capacity of six (6) with five (5) non ambulatory residents and one (1) bedridden resident. Facility sketch revealed bedroom labeled #1 is approved as a shared room for one (1) bedridden resident and one (1) non ambulatory resident, bedroom labeled #2 is approved for two (2) non ambulatory residents and bedroom labeled #3 and #4 are cleared for one non ambulatory resident each. During the physical plant tour LPA observed the garage had been converted into living quarters for the licensee and bedrooms labeled #2 and #3 are each currently occupied by licensee's family members. The Administrator stated that they intend to comply with regulations and will be submitting the required documentation.
Deficiency cited refer to (LIC809-D). Exit interview conducted. Appeals rights provided. Copy of report provided. |