Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted a case management visit to follow up on the initial case management visit on 8/5/25. LPA met with Staff and explained the reason for the visit.

The initial visit was conducted on 8/5/25 by LPA Cynthia Chan in response to the death of Client #1 (C1), who passed away on 7/25/25. During the initial visit, LPA Chan interviewed the administrator, collected documents, and toured the facility. There were no health and safety concerns noted. C1 was scheduled on 6/19/25 for a second surgery due to the colon cancer diagnosis. While at the hospital, C1 developed complications during recovery and later passed away.

LPA obtained a copy of the death certificate, which stated the cause was due to Cardiopulmonary Arrest, Sepsis, and Colon Cancer. It is confirmed that the death occurred at the hospital. Based on the information, the death was not questionable.

There is no further action required at this time. An exit interview was held, and a copy of this report was given to the staff.