Facility Evaluation Report
On 07/19/2023 Licensing Program Analysts (LPAs) L. Alexander and L. Hall arrived unannounced to conduct a Case Management visit to follow-up on a death report that was submitted on a Special Incident Report (SIR) received by Community Care Licensing on 03/07/2023. LPAs met with Caregiver, Stellah Mushi and explained the purpose of the visit.
SIR that was submitted indicated Client 1 (C1) passed away on 03/05/2023 with an unknown cause of death. LPAs spoke with Staff 1 (S1) and was not able obtain any additional information regarding C1's death. LPA's reviewed C1's file and did not observe a death report or death certificate.
During today's visit LPAs collected a copy of the following documents:
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction