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:11/26/2025 from the above facility, detailing the events of: 11/26/2025. LPA Trueman met with Administrator Caroline 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 11/26/2025 which included Physician's Report, Emergency ID, Medication Log ,and Needs and Services Plan.

LPA interviewed Administrator Caroline Tan at today's visit. The administrator stated that Client 1 had Stage 4 Lung Cancer and an elevated heart rate. Stated that Client C1 was seen by PCP on 11/20/2025 for routine follow up.

Last chemotherapy was with Oncology on 11/21/2025.

Death Report was submitted on 11/26/2025 and it states that on 11/26/2025 Client C1 at 5:12 AM collapsed on the 2nd floor hallway. Staff responded and immediately called 911. Paramedics arrived and attempted to resuscitate C1 who was pronounced dead at 5:51AM.

Cause of Death is undetermined at this time. Administrator will submit Death Certificate when received.

El Monte Police came to the facility and assigned Case #25048814.

There was no coroner involved in this case.

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

Exit interview conducted with Administrator and copy of report provided.