Incident investigation·July 31, 2025

Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced case management visit. LPA was greeted by, identified herself to, and explained the purpose of the visit with Caregiver Myrta Mompremier. LPA spoke with Administrator Rose Dorvilus via telephone during the visit. On 7/31/2025, the Department received an incident report from the facility regarding an alleged incident involving Resident 1 (R1) that occurred sometime in July 2025. [Caregiver was provided with an LIC811 Confidential Names List to identify R1] During today’s visit, LPA conducted a health and safety check, observed resident in care, reviewed facility records, and interviewed resident and staff. No deficiencies were cited on today’s date. An exit interview was conducted with Caregiver Myrta Mompremier, whose signature below confirms receipt of a copy of this report, the LIC811, and the Licensee Appeal Rights (LIC9058 3/22).