Facility Evaluation Report

Licensing Program Analysts (LPAs) Tricia Danielson, Javina George, Janira Arreloa arrived unannounced to the facility conduct a case management visit following receipt of a death report of Client #1 (C1)

LPAs reviewed file of C1 and made photographic copies of pertinent documents. LPAs also interviewed facility Administrator Jamielah Fortajada. Fortajada reported she was notified of C1's death by their mother that C1 passed away on 3/8/2022 at Riverside University Health System hospital.

There were no deficiencies cited during today's visit. An exit interview was conducted and a copy of this report was provided along with LIC 811- Confidential Names list.