Facility Evaluation Report

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced visit to the facility in order to conduct a case management on a recent death at the facility. LPA met with Administrator, Mae Embalsado. who was informed of the purpose of the visit.

LPA requested the file for R1 and a summary of events leading the residents death. It was determined that the facility completde the reporting requirements by verbal incident report to the LPA assigned followed by a written incident report to the regional office. The administrator was advised on documents that would need to be sent to the LPA as they become available. LPA reviewed the Guardian roster and verified all staff have been fingerprint cleared.

No deficiencies were issued at the time of the visit.

An exit interview was conducted and a copy of this report was reviewed and provided to Administrator, Mae Embalsado.