Facility Evaluation Report

Licensing Program Analysts (LPA) Abdoulaye Zerbo and Tremayne Barra made an unannounced visit to conduct a case management visit to follow up on a client's death. LPA met with assistant Administrator Angel Agavo and explained the purpose of today's visit. Administrator Larissa Madera joined the visit at a later time. LPAs toured the facility and did not observe any immediate health concerns or violations.

During the visit LPAs reviewed and collected pertinent documentation such as: ID/Emergency information, Physicians report, IPP, CDER, and medication records. LPAs also interviewed Facility staff members for further information in regards to the death of C1 and the events that led up to C1's death. C1's medications and MAR records were reviewed,

LPAs inquired about the cause of the death. A death certificate has not been issued at this time. LPA advised to send a copy of the death certificate to the regional office once received.

Administrator contacted Community Care Licensing via email to inform of the death on January 28, 2026.

An exit interview was conducted, a copy of this report was provided to Administrator Larisa Madera