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 02/25/2020. LPA Lopez met with Administrator Joey Alvarado and the reason for visit was explained.

On 02/25/2020, from 10:25 a.m. to 12:15 p.m., 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 02/21/2020. LPA Perera met with Business Office Manager Michelle Greenberg and Health and Wellness Director Vivian Reyes. The death report received reflected that Resident #1 (R1) was transported to the hospital on 01/30/2020 after sustaining a fall on the sidewalk outside the facility. R1 died at Los Robles Hospital on 02/18/2020 after being taken off the ventilator on 02/17/2020. During the facility visit, LPA Perera conducted a file review at 10:43 a.m. and obtained pertinent documentation relating to the incident. LPA also conducted a brief interview with Health and Wellness Director to obtain additional information at 10:59 a.m. LPA determined that further investigation was needed, and the case was referred to Community Care Licensing Investigation's Branch (IB) Investigator Joseph Balarie.

Investigator Balarie conducted an interview with Troy Byington, Facility Executive Director, on 03/10/2020 at approximately 9:40 a.m., and with facility staff and residents from approximately 11:00 a.m. to 12:10 p.m.; on 03/11/2020 at approximately 10:00 a.m. with R1’s conservator; on 04/10/2020 from approximately 1:10 p.m. to 2:00 p.m. with facility staff; and on 04/14/2020 at approximately 10:00 a.m. with Los Robles Regional Medical Center Doctor Elise L. Bukont. Facility records and medical records were also obtained and reviewed.