Facility Evaluation Report

On today’s date 9/29/2022, at 11:40 AM. Licensing Program Analyst (LPAs) L. Fici and C. Lin arrived unannounced to conduct a Case Management Visit. LPAs was greeted by care staff, Lynette Ocon at the front door entrance. Administrator, Rosealinda Amacan gave consent to care staff to sign the report in her behave.

LPA received an incident report which occurred on 9/10/2022, regarding a death in the facility. LPAs conducted record review with Staff (S1). C1 has a DNR on file and was placed on hospice care dated 8/17/2022. Facility has a Hospice order to place C1 on hospice. LPAs verified the cause of death with S1. LPAs observed staff following hospice order, monitoring C1, and documenting change of condition daily.

Exit interview conducted with care staff, and report provided