Facility Evaluation Report

Licensing Program Analyst (LPA) LPA Rosie Quiroz made an unannounced case management visit to follow up on a death report dated 11/24/2021 reported to Community Care Licensing on 11/29/2021. LPA Quiroz was greeted, COVID-19 screened and granted entry into the facility by Licensee/Administrator Almiranez, and explained the reason for the visit.

Death report dated 11/24/2021 indicated Resident 1 (R1) was visiting in his bedroom with his girlfriend. R1 was being fed chicken wings by his girlfriend and got choked. R1's girlfriend immediately called 911. Licensee/Administrator Almiranez indicated approximately 14 paramedics arrived to facility to respond to 911 call due to R1's history and diagnose of obesity.

Facility staff indicate R1 was on a cardiac controlled diet; however did not abide to cardiac controlled diet and often ordered fast food delivery, two to three times per week.

Per physician report dated 4/07/2020, R1 is diagnosed with A-Fib and Obesity. Licensee/ Administrator Almiranez indicated he received a call from Deputy Coroner's office on 11/29/2021 indicating R1's autopsy revealed massive heart attack. Family to provide death certificate to facility as soon as its available.

Facility to forward a copy of death certificate to LPA Quiroz upon receipt, and update incident report to reflect timeline of event reported during today's visit.

Exit interview conducted with Licensee/Administrator Almiranez and a copy of this report was left at the facility.