Facility Evaluation Report

Licensing Program Analyst (LPA) David Cuevas conducted an unannounced Case Management visit to facility regarding a death report received at regional office on 10/25/2021. LPA met with staff. Sabrina Administrator/Licensee, Richard Cazas was called and arrived at the facility shortly after.

During case management visit LPA interviewed Administrator, and reviewed residents #1 (R1)’s file.

Per interview and available records resident passed away on 10/22/2021 approximately 4:30 PM. Per staff interview, resident # 1 (R1) was using facility bathroom when staff noticed that R1 had been in there longer than usual. That is when staff proceeded to check on R1 and found R1 unresponsive, staff immediately called 911 paramedics. Staff proceeded to move R1 right outside bathroom and began CPR until the paramedics arrived approximately 4:11 PM and took over CPR; However, paramedics were unsuccessful in resuscitating R1 and pronounced decease at approximately 4:30 PM at the facility. During visit LPA requested and obtain the following documents:

3. Psychiatric Evaluation and Medical Notes/Orders