Facility Evaluation Report

Licensing Program Analyst (LPA) Debbie Palacios made an unannounced visit to conduct a case management visit for Client 1 (C1)’s death. LPA conducted a health and safety check and met Program Administrator, May Embalsado and explained the purpose of today’s visit. At the time of the visit, there was 3 (three) clients at the facility and 2 (two) staff members present at the time of the visit. Administrator May Embalsado arrived tot he facility shortly after.

During the LPA’s visit, LPA reviewed, requested, and obtained copies of pertinent documentation, conducted an interview with Administrator regarding C1’s death on 01/13/25. LPA interviewed to obtained further information regarding the death of C1 and the events that led up to C1’s death. According to Administrator, the cause of death was Multiple Organ Failure; however, Hospital documentation and Death Certificate is pending at this time. Administrator verbalized that she will be emailing LPA the Death Certificate when it becomes available.

No deficiencies were cited during this visit, as there were no health and safety concerns observed during today's visit.

An exit interview was conducted and a copy of this report (LIC 809) and LIC 811 (confidential names list) were provided.