Facility Evaluation Report

Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced Case Management Incident visit. LPA was greeted and granted entry by Licensee Shawquina Davis who was informed of the purpose of the visit.

The visit is in response to the death of Client One (C1), whom passed away on 03/05/2024. LPA conducted a tour of the facility, interviews, and collected documents. LPA reviewed C1's file and obtained copies of the following: ID/emergency Information, admission agreement, Physician's reports, Individual Program Plan, progress notes, and medication records (MARs) for the last 30 days.

During today's visit no deficiencies were cited in regard to this incident.

An exit interview was conducted, and a copy of this report was provided to Licensee Davis along with a copy of the LIC 811.