Follow-up·September 6, 2023

Licensing Program Analyst (LPA), Carmen Lopez conducted an unannounced visit to open a complaint investigation and conjointly conducted a case management visit for review of resident records. LPA identified herself and was granted entry by Executive Director Michael Sokolowski. LPA stated the purpose of the visit and reviewed the basic elements of the visit with Executive Director Sokolowski. On Wednesday, September 6, 2023, LPA Lopez initiated a complaint investigation that was submitted to the Department on August 29, 2023, for investigation. During the visit, LPA reviewed residents’ documentation and observed that resident #1 (R1’s) Physician’s Report (LIC602) was outdated. Based on records reviewed and LPA’s observations, it was determined that the facility did not keep R1’s LIC602 updated. The facility is being issued technical violation and can be found on the LIC 9102TV. An exit interview was conducted with Executive Director Michael Sokolowski and Brittany Blaul, Resident Service Director . A copy of this report along with Licensee/Appeal Rights (LIC9058 03/22) were provided to Executive Director Sokolowski at the conclusion of the visit. The signature below confirms the documents were received.