Facility Evaluation Report

Licensing Program Analyst (LPA) Lydia Martinez made an unannounced visit to the facility to conduct a Case Management - Incident to follow up on information regarding a Client's death. LPA met with Caregiver/MedTech Charlize Oviedo. Ms. Oviedo contacted Administrator (AD) Michelle Domingo to let her know of LPA's presence. AD Domingo arrived shortly after and LPA explained the purpose of today's visit.

During LPA's visit, LPA toured the facility, reviewed and obtained copies of pertinent documentation and conducted staff interviews regarding the death of Client 1 (C1) who passed away on 06/05/2023. LPA interviewed AD Domingo, and Staff 1 (S1) for further information regarding the death of C1 and the events that led up to C1's death. Per AD Domingo, the official Death Certificate has been not been issued at this time, as they are awaiting for the autopsy report from the Orange County Coroner's office.

There was no preliminary cause of death that was determined or provided. LPA advised AD Domingo to send a copy of the Autopsy report to the department as soon as it is available.

No deficiencies were cited during this visit.

An exit interview was conducted and a copy of this report (LIC 809) and LIC 811 (Confidential Names) will be sent to email on file.