Facility Evaluation Report

Licensing Program Analyst (LPA) KaSandra Lopez conducted a Case Management - Incident visit to issue final findings and citations related to the initial Case Management - Incident visit conducted on 02/20/2020. LPA Lopez met with Administrator Joey Alvarado and the reason for the visit was explained.

On 02/20/2020, from 9:15am to 12:40pm, LPA D. Perera conducted an unannounced Case Management - Incident visit to the above facility. The purpose of the visit was to follow up on a Death Report submitted to the Department on 02/17/2020. It was reported that on 02/13/2020, at approximately 6:25pm, Resident #1 (R1) was found on the bathroom floor unresponsive with weak and irregular pulse. 911 was contacted and arrived at the scene at 6:30pm and attempted CPR however, R1 was pronounced deceased at 6:45pm.

LPA Perera met with Administrator/Executive Director Troy Byington and explained the reason for the visit. On 02/19/2020, the LPA contacted the facility administrator and requested additional information regarding the incident. Additional documentation was obtained and reviewed by LPA. During the 02/20/2020 visit, LPA Perera conducted a file review between 9:30am - 10:15am and obtained pertinent documentation related to the incident. LPA also conducted a brief tour of the facility memory care unit at 10:20am. Prior to issuing a final licensing report, LPA determined that further investigation was needed, and the case was referred to Community Care Licensing Investigations Branch (IB) Investigator Joseph Balarie.

Investigator Balarie conducted interviews with Troy Byington, Administrator/Executive Director on 03/10/2020 at approximately 9:40am; facility residents at approximately 11:30am to 12:10pm; and Staff #1 (S1) on 03/11/2020 at approximately 8:40am. Facility records, medical records, and death certificate were also obtained and reviewed.