Facility Evaluation Report

Licensing Program Analyst (LPA) Glenn Trueman visited this facility as an unannounced Case Management Visit in connection to a Death Report received on: 01/31/2025 from the above facility, detailing the events of: 01/30/2025. LPA Trueman met with Staff Aristotle Tan and the purpose for the visit was discussed.

During the course of the visit, LPA reviewed Client 1's file. Various documents were submitted to Licensing on 01/31/2024 which included Physician's Report, Emergency ID, Medication Log ,and Needs and Services Plan.

LPA interviewed Staff Aristotle Tan at today's visit. The Staff Aristotle Tan stated that Client 1 in morning around 850 AM Med staff told him to check Client 1 in his room. Was very pale. Said he had chest pain and trouble breathing. He said last nite around 11 PM he felt it.

Oxygen low. He called 911 and then they sent him to Greater El Monte.

Death Report was submitted on 01/31/2025 and it states that on 01/29/25 Client C1 had complained of chest pain, shortness of breath and looked pale.

Client was admitted to Greater El Monte hospital with diagnosis of pneumonia, Sepsis, Hypoxia, Tachycardia, Respiratory failure, on oxygen of 6L.

Client was seen on 01/14/25 by his provider and was given antibiotic and cough medicine for Bronchitis.

On 01/30/25 Case Manager called and notified the client had expired at 12:30 PM.

Administrator will submit Death Certificate when received from family.

There was no police or coroner involved in this case.

Based on the available information reviewed, further investigation is needed.

Exit interview conducted with Staff Aristotle Tan.