Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced Case Management Incident visit. LPA met with Care Giver Ana Bell and explained the reason for the visit. The visit is in response to the death of Client 1 (C1), who passed away on 2/19/2024 and was reported to Community Care Licensing on 3/13/2024.

During the visit, LPA reviewed C1's file and obtained copies of the following: ID/emergency Information, Admission Agreement, Physician's reports, Inland Regional IPP, Progress/daily notes, Medication logs, medical appointments, and laboratory paperwork. LPA requested a copy of C1’s death certificate when it is made available.

C1 was admitted to hospital on 1//31/2024 for surgery.

During today's visit, no red flags were observed, and no deficiencies were cited regarding this incident.

An exit interview was conducted, and a copy of this report was provided to Care Giver Ana Bell .