Follow-up on corrections·March 22, 2022

Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced for the purpose of investigating a complaint (#18-AS-20220317170451). During LPA Colvin's inspection, the following observations were made: Unavailable Records for Inspection - In relation to the aforementioned complaint investigation, LPA Colvin requested to see an updated Admissions Agreement and fee schedule breakdown for a resident (R1), as only the original Admissions Agreement from 2017 was present in the file. After an extended period of time, Business Manager Joselynn Munoz informed LPA Colvin that she was unable to obtain a copy of the Agreement from her contact at the company's regional office, and could not confirm how the document is stored. Business Manager Joselynn additionally examined the file for R1 which had been provided to LPA Colvin, and could not locate any updated information for R1's new charges for care at the facility. Deficiency cited. Lack of Required Approval/Signatures - After Business Manager Joselynn had contacted the company's regional office to inquire about the new Admissions Agreement and proof that it was provided to R1's Power of Attorney (POA), Joselynn informed LPA Colvin that she was advised that the Licensee did not require for the new Admissions Agreement to be signed, therefore, the facility (and regional office) does not have a signature on file for the new Admissions Agreement and charges for R1. Deficiency cited. Changes in Plan of Operation - Prior to arriving at the facility, LPA Colvin reviewed Community Care Licensing's (CCL) file for the facility, including the Admissions Agreement which was approved with the facility's license in 2020. LPA Colvin observed that the Admissions Agreement on file with CCL does not follow the same fee structure (points versus levels) that is reflected in R1's billing history. Additionally, consultation with the LPA that oversees this facility (LPA Stephanie Torres), confirms that CCL has not received anything from the Licensee in regards to major changes in the facility's operation, such as changes in the Admissions Agreement and how residents are charged for care provided. Deficiency cited. Past Due Licensing Fees - Prior to LPA Colvin's arrival at the facility, LPA Colvin reviewed the facility's standing with CCL, which includes the timely payment of annual licensing fees. LPA Colvin observed that the licensee is currently behind in payment with the facility's annual fees, and has accrued a late fee as a result. Current outstanding balance owned to CCL is $2,973.00. Deficiency cited. LPA Colvin conducted an exit interview with Resident Care Director William Lewallen, where a copy of this report, LIC809D, and appeal rights was provided.