Facility Evaluation Report

Licensing Program Analyst is conducting this case management for the purpose of a health and safety evaluation in response to the incident reporting the death of C1 on 08/17/2022. LPA collected records for C1. LPA conducted a tour of the facility and grounds, assessing the physical plant, staffing, food supply, and general care of clients. Clients are present during this tour engaged in various activities of choice. There are four caregivers and five clients in the home at the time of this visit. Sufficient staff are present at the facility to provide care. LPA observed three (3) days supply of perishable and seven days (7) supply of non-perishable food. No imminent health and/or safety concerns identified at the time of this visit

This report was reviewed with and a copy was provided to Carlito Tan during the exit discussion.