Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced case management visit in response to a death report received on 12/18/2024 for Client #1 (C1). LPA met with Jacinta Abanobi, Direct Support Staff (DSP) for the facility, and explained the purpose of the visit. Ifunanya Ifeacho, acting administrator for the facility, explained the purpose.

Per the Special Incident Report (SIR), C1 was taken to the hospital after complaining explaining they were not feeling well on 12/17/2024. Staff proceeded to drive C1 to the hospital, and once they arrived at the hospital C1 collapsed to the floor. Hospital staff pronounced C1 deceased shortly thereafter.

During today's visit LPA Ifunanya who explained that when they arrived at the hospital, C1 had slumped over after walking for about 10 meters, which prompted them to call hospital staff for assistance. Hospital staff proceeded to perform CPR on the client, however they did not make it.

Staff #1 (S1) emailed LPA C1's Physician's Report, FACE Sheet, Individual Program Plan (IPP), and their Medication Administration Records (MARs) for the past three (3) months. Staff explained that they will email LPA a copy C1's death certificate once it becomes available.

LPA conducted a health and safety check of the facility, including a tour of C1's bedroom. No concerns, obstructions, or anything out of the ordinary was witnessed during the visit.

No deficiencies were observed during today's visit. Exit interview was held and a copy of the report was provided.