Facility Evaluation Report

On 02/02/2023 at 2:40PM, Licensing Program Analyst (LPA) L. Ibo conducted an unannounced case management about Death report received on 01/30/2023, R1 passed away with unknown cause of death. LPA met with Administrator, Rakhee Sharma.

During the course of investigation, based on the interview with staff, R1 did not show any signs of medical emergency throughout the day. At around 2:00PM-4:00PM R1 took a nap. At around 3:30PM, S2 checked R1, it was observed that there was no sign of any medical emergency. R1’s family member visited her. Family member of R1 found her unresponsive at around 04:30PM. Staff called 9-1-1, paramedics arrived and pronounced R1 death at 4:43PM.

R1 passed away on 01/29/2023. Based on Police report it revealed that there was no foul play or any sign of abuse.

Based on interview with Administrator, R1 was under the care of hospice from 01/24/2022 and was discharged on 04/23/2022 with admission diagnosis of Cerebrovascular disease.

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