Facility Evaluation Report

Licensing Program Analyst (LPA) Albert Marin made an unannounced visit to this facility to conduct a case management for an incident. LPA was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedures. Administrator (AD) Jessica Garcia arrived in the facility shortly after. LPA stated the purpose of this visit.

On October 25, 2021, The Community Care Licensing Division (CCLD) Orange Regional Office received a report from this facility indicating that about 2:09 AM of the same day, Facility received a report that , Client 1 (C1) passed away while admitted in the hospital. Client 1 had been in a hospital set up since October 4, 2021.

For this visit, LPA Marin conducted a tour in the interior of the facility and observed three clients in care and five staff members on the floor. LPA conducted interviews and reviewed records that included but not limited to admission agreement, physician's report, needs and services plans, incident reports, observation logs, and hospital records.

For this visit no citation was issued at this time.

LPA Marin conducted an exit interview with AD J. Garcia; and copy of this report was left in the facility.