Facility Evaluation Report

On 5/22/2026, Licensing Program Analyst (LPA) Kelly Nguyen conducted an unannounced case management regarding an incident report that was submitted to CCLD on 3/14/26, regarding a client 1 (C1) who had a respiratory arrest during C1 day program. LPA met with care staff member Ellen Jovero and explained the purpose of the visit. Administrator (ADM), Frank, was informed and explained the purpose of the visit, but was not able to come during that time. ADM gave verbal permission for Ellen to sign the report.

ADM reported that on 3/13/26, at about 11:30 AM, C1 had a respiratory arrest at the DAY PROGRAM (TINs Adult Day Program). The Facility Director called ADM about the incident at around 11:45 AM. The initial SIR was done by the Day Program. CPR was performed at the Day Program, and the patient was immediately transported to the hospital by ambulance.

C1 was admitted to the ICU at Washington Hospital. According to the Nurse in charge, C1 has a respiratory arrest secondary to cardiac arrest. On 3/14/26, C1 is still in the ICU at this time. C1 was admitted due to cardiac arrest. C1 was admitted to the ICU from 3/13-3/25/26 at Washington Hospital, Fremont. He was discharged with a tracheotomy and PEG tube feeding. On 3/25/26 at about 10 AM, C1 was transferred to Kindred Hospital, San Leandro, from 3/25-4/22/26. On 4/23/26, C1 was transferred to Alameda Healthcare and Wellness Center for further treatment.