Non-compliance follow-up·October 30, 2025

On October 30, 2025, Licensing Program Analyst (LPA) Kayla Adkison arrived at the facility unannounced to conduct a Case Management/Legal visit in accordance with the Stipulation and Order effective November 3, 2023 - November 3, 2025. A copy of the Stipulation and Order is posted in a conspicuous place and is available for review upon request. LPA met with the Administrator, Cliff Keene, and was granted access to the facility. During the visit, LPA reviewed the following stipulations of the order: 1. Staff shall be sufficient in number, qualifications, and competency and shall provide additional back up staff to provide the services necessary to meet residents’ needs · During the inspection, LPA observed LIC 500 and staff schedule and found staff to be sufficient in number. LPA observed training that was conducted from May 2025 to October 2025, which was found to be sufficient. 2. Facility shall inform all current and prospective residents and/or responsible parties of the facility’s probationary license by providing to the residents/residents’ responsible party a copy of the stipulation. · LPA observed notification within (5) five of (5) five resident files that they or their responsible party was notified of the stipulation. LPA observed notification of the stipulation for new residents in the admissions agreement. 3. Facility shall ensure that each resident is able to receive three nutritionally well-balanced meals which within 30 days of the effective date of the stipulation shall incorporate the policy of maintaining a Daily Resident Meal Check List into the plan of operations. · LPA observed Daily Resident Meal Check list for the month of October 2025 which is sufficient in ensuring that residents are receiving meals, and staff are regularly checking on residents should they choose not to receive meals. The Daily Resident Meal Check List is in the plan of operations, as required by the stipulation. Report continued on LIC-809C 4. Facility shall submit a written summary of hiring and training practices, including job descriptions to the licensing agency. · LPA has observed hiring and training practices, including job descriptions in the Plan of Operation. 5. Facility staff shall submit any unusual incident reports to the licensing agency by the next working day and a written report to be submitted to the licensing agency within seven days following the date of the incident. · LPA has observed that the facility has been reporting incidents timely and submitting the required information to the licensing agency appropriately. The facility is in compliance with the terms and conditions set forth in the Stipulation Order. No deficiencies were cited as a result of this inspection. This will serve as the final visit of the probationary term. Exit interview conducted and a copy of the report was provided to Administrator, Cliff Keene, via email