Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted a case management visit to follow-up on an initial case management visit that was conducted on 8/20/2024. LPA met with Gabriella Ortiz, Direct Support Staff for the facility, and explained the purpose of the visit. Evelyn Guerrero, House Manager, arrived shortly thereafter. The initial visit was conducted in response to the death of Client #1 (C1), who passed away on 8/14/2024.

During the initial visit conducted on 8/20/2024, LPA interviewed the administrator Crystal Alegre, and also obtained C1's Physician's Report, FACE Sheet, Appraisal/Needs and Services Plan, and their Medication Administration. LPA requested a copy C1's death certificate once it became available. LPA also toured the bedroom of C1 and found no concerns.

On 11/4/2024 the death certificate for C1 was provided by Crystal Alegre, which explained that the cause of death was due to Arteriosclerotic Heart Disease. The medical conditions which contributed to the immediate cause of death was a leaking heart valve. The death has been determined to not be suspicious.

At this time, no further action is required and no citations will be issued. Exit interview held and a copy of this report was provided.