Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection regarding a death report recently submitted to the Department. LPA met with caregiver, Robert Kovacs, and explained purpose of inspection. Administrator, Eva Nemethy, was contacted by phone.

LPA and the caregiver discussed the recent passing of prior resident (R1) on June 19, 2026, who was not under hospice care. The caregiver stated that (R1) had been declining for several months, and the decline was reported to the administrator, and (R1's) health care provider. The caregiver described (R1's) decline to include a decline in appetite, episodes of vomiting and more frequent diarrhea. The caregiver stated that (R1's) health care provider indicated the diarrhea could be a reaction to medication changes. The caregiver stated that he contacted 9-1-1 on June 16, 2026 due to (R1) showing these symptoms, and (R1) was discharged back to the facility later in the day, in the same condition. Both the administrator and caregiver confirmed, (R1) saw a physician from their primary care group on June 15, 2026 and lab tests were ordered.

LPA reviewed the hospital discharge papers which note (R1) was seen for vomiting and GI bleeding and had a discharge diagnosis of Urinary Tract Infection, vomiting and gallstones. Two new medications were prescribed- LevoFLOXacin 750 mg (7 days) and Zofran 4mg (3x/day for 3 days). LPA reviewed medication counts for both medications and confirmed (R1) received both medications for (3) days, as prescribed, until passing. The caregiver stated there are delays at times with this health care company picking up medications and delivering it to the facility. The caregiver stated the California Hwy Patrol arrived just prior to emergency personnel arrived at 11:27 am on June 16, 2026. LPA requested a copy of the county death certificate when available , and the Administrator agreed to provide one . The facility will submit an amended copy of the death report (LIC624A) to reflect an accurate year and place of death. There are no deficiencies cited in this report. Exit interview with caregiver. Copy of report provided.