Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted a case management visit for the death of a client. LPA met with staff, Emilio Rances and explained the reason for the visit. The facility submitted a death report on 7/15/22 regarding death of Client #1.

Per the Administrator and Staff #1, Staff noticed that Client #1 was a little bit weak starting in the afternoon on 7/13/22. Staff took Client's temperature and did not have a fever. Staff did not see any signs of distress or emergency needed. The Client appeared normal except for being a little weak. The next day on 7/14/22, Client did the normal routine in the morning and after lunch, client took a rest. Temperature and vital signs were normal. When Client #1 asked to go to the restroom, staff #1 assisted in changing the diaper. The Client fainted and fell to the bed, unresponsive. Staff immediately performed CPR while another called 911. The paramedics came and took over the CPR. Client #1 was pronounced deceased on 7/14/22 at the facility.

LPA obtained copies of the Face Sheet and Medication log from May through July 2022. The Administrator will email the Physician's Report and Regional Center IPP later today.

LPA requested for a copy of the death certificate when it is obtained.

An exit interview was conducted and a copy of this report was given to the Administrator.