Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced case management visit in response to a death report received on 4/1/2025 for Client #1 (C1). LPA met with Jourdan Sanvictores, administrator for the facility, and explained the purpose of the visit.

Per the Special Incident Report (SIR), C1 was found in their room by staff at around 2:00 AM in their room and was non-responsive. Paramedics were called after it was discovered C1 did not have a pulse, paramedics arrived and pronounced C1 deceased at 3:15 AM. Staff explained that there were no signs that C1 had any issues with their health in the days leading up to their passing, and there is no suspected cause of death at the moment.

During today's visit LPA toured the facility and also the bedroom of C1. No health or safety concerns were noted during the visit.

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.

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