Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced Case Management Visit to follow up on a Special Incident Report 4/22/26 and Death Report the Department received on 4/27/26. LPA met with Lourdes Almeida and explained the reason for the visit.

The Department received a Death Report dated 4/27/26 indicating the following:

On 4/1/26 C1 left with their mother for a dentist visit, C1 had a negative reaction to the general anesthesia and was intubated, and then admitted into the intensive care unit with no additional information provided by the mother regarding cause of death.

*LPA advised Administrator that the Death Report must be updated and details of when C1's mother called to notify facility of C1's death, along with date of call, date of death and any additional information that was provided*

On 4/28/26 LPA received copies of the following documents from C1's file via email. Face Sheet, Annual, Regional Center Individual Service Plan (IPP) dated 2/1226, Quarterly IPP dated 1/31/26, Copies of most recent follow-up physician visits dated 1/13/26 and 12/2/25, Regional Center IPP dated 10/29/25, and Medication Administration Records (MAR) for the past 3 months (February-April 2026), and Physicians Report dated 6/3/25.

During todays visit LPA toured C1's bedroom. (there were no concerns, obstructions, or anything out of the ordinary observed)

LPA has requested facility to obtain and provide Licensing with C1's Death Certificate upon receipt.

No deficiencies were issued during today's visit. Exit interview held and a copy of the report was provided.