Facility Evaluation Report

Licensing Program Analyst (LPA) Quoc Huynh conducted an unannounced Case Management visit after the facility self-reported a resident’s death. The LPA arrived at 12:29PM and met with Interim Executive Director (ED) Virginia Sumulong. Entrance interview conducted.

On 01/15/2026, the Department received a death notification for Resident #1 (R1) who passed away on 01/14/2026. The notification did not document a cause of death to which the LPA contacted the ED on 01/16/2026. The ED stated they are awaiting a death report from the coroner’s office and that they were provided a preliminary cause of death of blood loss. Additionally, it was reported that local law enforcement responded to the facility and investigated R1’s death.

During today’s visit beginning at 12:39PM, the LPA and ED conducted a physical plant tour, and no immediate concerns were observed. At 12:52PM, the LPA reviewed and obtained pertinent documents. The ED was advised that the case was referred to Community Care Licensing Division’s (CCLD) Investigations Branch (IB).

The LPA determined that further investigation is needed.

No deficiency cited. Exit interview conducted. A copy of today’s report was reviewed and provided.