Facility Evaluation Report

On 09/05/2024, Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility to conduct case management visit follow up regarding an incident that occurred on 08/31/2024 as facility reported on 9/1/2024. LPA met with staff, Jean Gonzales and explained the purpose of the visit.

The visit was in response to a report from the facility regarding an incident that occurred on 08/31/24. According to the report, on 08/31/2024, at around 9:45 PM, resident, R1 was leaving the facility with staff for a shopping trip when R1 experienced a change in condition. The facility contacted local law enforcement and emergency services, but R1 passed away at approximately 10:20 PM. The facility notified all relevant parties involved regarding R1 passing.

During the visit, LPA Bains conducted a reviewed R1s file and interviewed three staff members and three residents. LPA is requesting relevant documents related to the incident. All these requested documents shall by submitted via email to LPA Bains by 09/08/24.

At this time, this incident is under review and department will do follow up if warranted.

Exit interview conducted and copy of the report left at facility.