Senior Care Records.

Facility Evaluation Report

Kenneth Adult Residential V, Chino03/11/2024Licence 366426704

Capacity6
Date signed03/11/2024 12:06:39 PM
The inspector’s account

Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a case management visit regarding a client death. LPA Prieto met with Administrator Rosa Olibares and discussed the elements of the visit. Client #1 was last at the facility on March 6, 2024. 911 was called and C1 was transported to a medical facility where C1 was in ICU. Facility staff arrived to the medial facility at approximately 8:30 AM on March 7, 2024. Medical staff stated to facility staff #1(S1), the C1 was doing OK. Approximately, 10 minutes later, medical staff performed CPR for approximately 25 minutes later medical staff declared C1 had passed away. Medical staff stated to S1 that C1 had not given a definitive cause of death at this time.

LPA obtained residents records that included Physician report, Primary Care Physician visit summaries for February and January 2024, Psychiatric reports, Pulmonary report, C1 daily reports leading to C1's hospital visit and subsequent passing.

C1 passed away under the care of the medical facility. Final doctor's summary of the death are yet to be released to the facility staff or family members. Primary Physician had seen C1 in January and February of 2024 and the last reports were obtained by LPA Prieto during this visit.

This report was signed by LPA Prieto and Administrator Olibares and a copy was left at the facility.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction