Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted a case management visit in regards to a death report received for Client #1 (C1), who passed away on 3/13/2026. LPA met with Administrator Susan Martinez and explained the purpose of the visit.

According to the death report, C1 was reported that they were experiencing shortness of breath. Staff contacted 911 and C1 was transferred to the hospital. On 3/13/2026, C1 had passed awhile while at a hospice house affiliated with the hospital. The cause of death is suspected to be due to pneumonia and end stage renal disease.

During the visit LPA obtained C1's Physician's Report, FACE Sheet, Individual Program Plan (IPP), and their Medication Administration Records (MARs) for the previous two (2) months, and FACE sheet. LPA requested that the administrator submit a copy C1's death certificate to LPA once it became available. LPA also toured the bedroom of C1 and found no concerns.

No deficiencies were observed following the visit. Exit interview held and a copy of this report was provided.