Facility Evaluation Report

Licensing Program Analyst (LPA) Stephanie Cifuentes initiated a case management visit regarding an incident reported to CCL on 10/8/2021. LPA arrived at 1:00pm and called Eve Tighe to complete facility risk assessment. LPA informed staff that the reason for the visit was due to the incident which occurred on 10/8/2021 and was allowed entry.

During todays’ visit LPA interviewed administrator, staff and toured physical plant. On 10/8/2021 client 1 (C1) was found by staff 1 (S1) on floor of bathroom. S1 went to get administrator, who attended to client, while S1 called police and paramedics. Cause of death was deemed natural causes.

LPA requested the following documents: Staff roster, staff schedule, IPP, IBSP and Physicians Assessment for C1.

A request was made to provide a copy of the death certificate when it becomes available.

No deficiencies will be cited at this time, additional investigation is required which includes analysis of the records obtained and follow up interviews.

Exit interview held and a copy of report provided to administrator Diana Renteria.