Facility Evaluation Report

Licensing Program Analyst (LPA) Stephanie Williams made an unannounced visit to the facility in order to initiate a case management visit due to a recent death of a client at the facility. LPA Williams identified herself to Staff Lead, Paulino Esquillo, who was also informed of the purpose of the visit.

On November 30th 2021, the Department was notified of the death of Client #1 (C1). During today's visit, LPA Williams interviewed Staff #1 (S1) and Staff #2 (S2) regarding the details surrounding C1's death. LPA Williams also collected records that are pertinent to C1's death, including:

C1's Inland Regional Center Client Development Evaluation Report

C1's Medication Administration Record (MAR)

LPA Williams also requested additional documentation be sent to the Department; such as, the Coroner's Report and a Death Certificate upon availability.

An exit interview was conducted where this report was discussed and a copy was provided to Esquillo at the conclusion of the visit.