Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted a case management visit regarding the death a client. LPA met with Assistant Administrator, Jaem Tan, and explained the purpose of the visit.

The department received notification of Client #1's (C1) death on 9/21/23. C1 passed away on 9/20/23 at the facility. It was reported that on 9/20/23, C1 was in the bathroom #5 and was taking longer than usual. Staff went to check on client and found C1 lying unresponsively in the bathtub. 911 was called. Staff was performing CPR until paramedics arrived and took over. C1 was later pronounced dead at 3:13pm.

During the visit today, LPA interviewed the Assistant Administrator, Staff #1, and a Client. Per interviews, C1 appeared to be doing ok and acting normal self prior to passing. They stated C1 had a history of seizures.

LPA reviewed C1's file and was medication compliant. C1 saw the doctors regularly.

LPA requested for a copy of the death certificate once it is obtained. An exit interview was held and a copy of this report was given to Ms. Tan.