Facility Evaluation Report

On 4/12/2023 Licensing Program Analyst, LPA Alfonso Iniguez conducted a Case Management visit to follow up on the death reported for Client #1 (C1). LPA was greeted by Mary Montiano/Administrator 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 and reported the death of (C1) on 4/10/2023. The death report stated that on 4/7/2023 (C1) was found by staff #1 (S1) on the floor unresponsive and unconscious. Staff #1 called 911 emergency. Paramedics came and checked C1 pulse and pronounced C1 dead.

LPA toured the physical plant. There were no bodies of water or obstructions on the premises. Resident rooms were inspected, beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the client's personal belongings was observed.

A copy of the following documents was provided to LPA:

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time.

An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to the Administrator/Mary Montiano.