Facility Evaluation Report
On 01/26/2026 at 4:45 PM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct a case management visit regarding a death report that was sent to licensing on 08/11/2025. LPA met with Assistant Executive Director, Sarah Husain, and explained the purpose of the visit.
While LPA was at the facility for another visit, LPA conducted an interview with S1 regarding R1's care and services that was provided to R1. S1 indicated that R1 passed away in August 2025.
LPA obtained the following documents including but not limited to R1's physician report, care plan, medication order, post acute summary report, centrally stored medication and destruction record,resident emergency information, and physician fax report.
LPA is requesting for a death certificate from the facility.
Exit interview conducted and a copy of this report provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction