Facility Evaluation Report
Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced Case Management Visit to follow up on a Death Report faxed to the Department on 12/24/2024. LPA met with Angela Panes - LVN and explained the purpose for todays visit
On 12/15/2024 C1 was hospitalized for pneumonia, on 12/18/24 C1 was placed on comfort measures while in the hospital where they expired on 12/24/2024.
The Department received a copy of the Death Report on 12/24/24 along with the following copies from C1's file: Individual Service Plan dated 10/22/24, Face Sheet, Needs and Service Plan dated 10/21/24, Physician Report dated 5/22/24, and Medication Administration Records from Oct-Nov-Dec 2024.
During todays visit LPA toured C1s room and interviewed LVN Angela Panes.
No concerns, obstructions, or anything out of the ordinary was witnessed during the visit.
LPA has requested facility to obtain and provide Licensing with C1's Death Certificate upon receipt.
No deficiencies observed during today's visit. Exit interview held and a copy of the report was provided to Angela Panes - LVN.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction