Facility Evaluation Report

Licensing Program Analyst (LPA) Yolanda Delgado conducted an unannounced Case Management Death Report visit. LPA was greeted by Brooke Abrego-Huerta, Executive Director. LPA explained the purpose of the visit. The visit is in response to the death of Resident #1 (R1), that was reported on 09/09/2024 to have died of unknown cause on 09/07/2024.

During LPA's visit, LPA reviewed R1's file and obtained copies of the following: ID/emergency Information, admission agreement, Physician's report, Appraisal/Needs and Services Plan, physician's orders, POLST, Medication list, three (3) statements and email notifications to CCLD. LPA also requested a copy of R1s death certificate when it is made available, and staff schedule for 9/6/2024 and 9/7/2024.

During today's visit no deficiencies were cited.

An exit interview was conducted, and a copy of this report was provided to Brooke Abrego-Huerta along with a copy of the LIC811.