Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced case management visit to address an incident report received on 12/22/2025 which detailed the passing of Client #1 (C1). LPA met with Abdulsemiu Ogun, Direct Support Staff for the facility, and explained the purpose of the visit. Administrator Lan Ly was notified of the visit by phone call.

In the death report received on 12/22/2025, it details that C1 had a seizure out in the community, and 911 was immediately called by staff. On route to the hospital paramedics noted that C1 had begun to go into cardiac arrest. Once they had arrived at the hospital, chest compressions were performed at the emergency room however C1 ultimately passed away.

Administrator Lan Ly explained that she will email LPA the Physician's Report, IPP, and Medication Administration Records (MARs) for C1 for the past 2 months, and will also submit the death certificate for C1 when it becomes available.

Following the visit, no deficiencies were observed. Exit interview was held and a copy of the report was provided.