Facility Evaluation Report
Licensing Program Analyst (LPA) Calderon and LPA Pena conducted an unannounced initial case management visit regarding the death of client #1 (C1) which occurred on on 5/24/22. LPAs met with staff Administrator Maura Panganiban and explained the reason of the visit .
During today's visit C1's file was reviewed and obtained the following:
Most recent Physician Report - April 28 , 2022
Name of Police Office and Contact Information : Glendale Police / Phone #
On 5/24/22 LPA Calderon received an incident report in which the death of C1 was reported. The same day of death LPA Calderon obtained C1's Death Report, Consumer Information Sheet, Individual Program Plan (IPP), Medication Sheet Log for months , March, April and May 2022.
During today's visit LPA's interviewed the Administrator S1 , DSP worker S2 , C1s roommate (C2) and clients Mother. Mother whom is the conservator will provide the police report, death certificate and autopsy when they become available.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction