Facility Evaluation Report

Licensing Program Analysts (LPAs) Erik Zaragoza and Gabriela Castro conducted a case management visit in conjunction with a complaint that has the control #28-AS-20250922154228.

During record review of the Serious Incident Reports (SIRs) received by the facility, LPAs determined that no death reports have been received for Client #1 (C1) identified in the complaint, who passed away on 8/4/2025. During interviews with S1, they explained that they have not faxed the death report for C1, nor for two (2) additional residents, because they were under the impression that a death report was not required to be sent to the department if the resident passed away in the hospital or was on hospice. LPAs advised that death reports will still have to be faxed to the department in such cases.

The related deficiency is cited on the LIC809D page. A copy of this report along with the appeal rights were provided.