Facility Evaluation Report

On 11/21/2024 at 3:00 PM Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct a case management visit to follow-up on a Special Incident Report and Death Report received by Community Care Licensing on around 05/29/2024 . LPA met with Direct Support Professional, Stella Mushi and explained the purpose of the visit.

R1 passed away on 05/27/2024 with an unknown cause of death. During today's visit LPA interviewed staff (S). S1 stated that they were on duty and hadn't seen R1 all day. S1 stated when S3 came to the facility they went to R1's bedroom and found R1 laying on the floor. S2 stated that there was exercise equipment up against the door as to set-up like a barricade. S2 stated that S3 called 911 and the police arrived and then the coroner came and removed the body. S1 and S2 stated that the burial was within days being that R1 was Muslim. S2 stated that they requested a copy of R1's death certificate from his brother but then the brother wouldn't respond and give a copy of death certificate.

Exit interview conducted and a copy of this report was provided.