Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted a subsequent 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 stage renal disease.

During the initial visit conducted on 3/20/2026, 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 also toured the bedroom of C1 and found no concerns.

Since the initial visit, administrator Susan Martinez submitted the death certificate of C1 to LPA, and it reveals that C1 passed away due to acute respiratory failure, with secondary factors including chronic respiratory failure and chronic obstructive pulmonary disease.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are UNSUBSTANTIATED.

An exit interview was conducted. A copy of this report, along with the appeal rights, was provided.