Facility Evaluation Report
On 06/01/2026 at 11:00AM, Licensing Program Analyst (LPA) T.Syess-Gibson arrived unannounced to conduct a case management visit to follow-up on a death report received by Community Care licensing on 05/28/2026. LPA met with Lorica Hipolito, Licensee, and explained the purpose of the visit.
Resident 1 (R1) passed away on 05/28/2026 with an unknown cause of death. Licensee stated the cause of death still has not been determined.
During today's visit LPA obtained the following documents: Facility’s resident roster (LIC9020), staff schedule (LIC500), R1’s admission agreement, Physician’s report and home health care notes dated 05/01/2026-05/27/2026.
LPA requested from facility a copy of R1's death certificate once available.
Exit interview conducted and a copy of this report provided .
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction