Facility Evaluation Report

Sunol Creek Memory Care, Pleasanton09/01/2023Licence 019200484

Capacity46
Census32
Date signed09/01/2023 03:39:21 PM
The inspector’s account

On 9/1/2023 at 2:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a case management visit in regards to death report received on 8/23/2023. LPA met with Health Service Director, Carolyn Appeal and explained the purpose of the visit.

LPA received death report on 8/23/2023 for resident (R1). Death report revealed that R1 passed away at the hospital on 8/18/2023. R1 was sent to the hospital on 8/7/2023 due to respiratory distress.

LPA interviewed staff and obtained R1's documents (physician's report, care plan, and care notes). LPA was informed that R1 sent out to the hospital on 8/7/2023 due to low oxygen level. Facility staff followed up with the hospital after R1 was admitted. Care notes indicated that R1 was tested positive at the hospital on 8/7/2023 and was admitted to ICU with diagnosis of respiratory failure. Physician's report dated 4/25/2023 indicated that R1's diagnosis include COPD and atrial fibrillation.

No deficiencies are being cited on this date.

Exit interview conducted. A copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction