Facility Evaluation Report

On 01/18/24 Licensing Program Analyst (LPA) Felisa Shirley conducted a Case Management visit to follow up on the death reported for Client #1 (C1). LPA was greeted by Zoie Clark. LPA spoke with Zoie and explained the purpose of the visit was to gather information surrounding the death of (C1).

The regional office received a copy of the death report from the facility who reported the death of (C1) on 12/19/23 at 9pm. The death report stated that approximately 9:00pm on 12/19/23 (C1) was found by staff #2 (S2) in her room on the bed. Client asked staff for water. When staff returned to give water to client, client screamed and her eyes rolled back. Paramedics were dispatched, paramedics arrived and performed CPR on client for cardiac arrest but client (C1) passed away.

· Physician Report for Community Care Facilities

No deficiencies were cited during this visit.

An exit interview was conducted with Zoie Clark and a hard copy was provided.