Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Case Management Visit-Incident on 03/16/2026. LPA was greeted by Administrator Mariano Prieto and explained the purpose of the visit.

On 03/10/2026, LPA Ramirez received a Vendor Special Incident Report for Consumer Death (ELARC-QA#268-A) for client#1 (C1). According to this report C1 was admitted to a local hospital on 02/07/2026 after staff noticed C1 did not look well. On 03/09/2026, C1 was admitted into hospice care and passed away later that evening at a local hospital.

On 03/16/2026, LPA Ramirez conducted a wellness check and toured four (4) client rooms. LPA Ramirez conducted three (3) staff interviews (S1-S3) and requested and obtained copies of C1’s physician’s report, face sheet, Individual Program Plan (IPP), and Medications Administration Record (MAR) for January 2026 and February 2026. Administrator Prieto agreed to submit a copy of C1’s death certificate as soon as he receives it from C1’s family.

No deficiencies were made during this visit. Exit interview was conducted and a copy of this report was provided.