Facility Evaluation Report
On 02/14/2025, Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Case Management Incident visit regarding the unexpected death of client#1 (C1) on 02/10/2025. LPA Ramirez was greeted by Administrator Jorge Romero and explained the purpose of the visit.
On 12/10/2025, LPA Ramirez received an Incident Report regarding the unexpected death of C1. On 1/24/2025, staff was performing routine vital signs check on clients and noticed C1’s oxygen levels were low. Staff re-checked C1’s vitals and determined emergency services were required and staff called 911. C1 was transported via ambulance to Montclair Hospital and C1 was admitted. On 2/8/2025, C1 was placed on hospice care and on 2/10/2025, C1 passed away.
LPA Ramirez requested a copy of C1 Death Certificate and hospice documents. LPA Ramirez obtained copies of C1’s face sheet, centrally stored medications and destruction log, medications administration record for 11/2024. 12/2024, and 1/2025, physician’s orders, Individual Program Plan (IPP), and physician’s report. LPA Ramirez may return at a later time to gather more documents in regard to this visit.
No deficiencies were observed during this visit. Exit interview was conducted. A copy of this report was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction