Facility Evaluation Report

Licensing Program Analysts (LPA) Hansen arrived unannounced to conduct a Case Management and was greeted outside of building by (Mgr of Peterson Hall) Rosemond who informed, over the weekend they had 2 clients and 1 staff test positive for COVID. LPA donned appropriate garb for visit.

At 9:25am LPA met with Administrator Stacy Anderson and Roderic “Rob” Robinson Director of Residential Services following up on a self-reported Incident Report received on 5/3/22 & 5/4/22 about a death of a client who resided at the facility. LPA spoke with Roderic Robinson Director of Residential Services. C1 died at Marin General Hospital on 5/4/22. Staff notice that client was not looking well on 4/21/22 and was seen by primary care doctor in office and given antibiotics. On 4/23/22 client presented significantly worse, 911 was called and was taken to the hospital. Client showed no symptoms prior to 4/19/22. C1 was diagnosed with Pneumonia and Sepsis and admitted to the hospital (ICU). C1’s condition deteriorated while in ICU, with low brain activity, being put on a ventilator and having seizure activity. C1’s family decided to stop life sustaining measures. C1 died at hospital on 5/4/22.

LPA interviewed staff and acquired documents.

Administrator contacting conservator for additional documents (D.C. & Hospital records)