Facility Evaluation Report

LPA"s Rohit Lama, Bernadette Allen and Javier Prieto made an unannounced visit to the facility there were two employees (Staff 1) and (Staff 2) and Administrator Valerie Coronado. The visit was conducted because of death report received 11/12/2021. The death occurred on 11/4/2021 while (Staff 3) was working. LPA's were there to receive documents for R1 Passing which administrator Valerie has agreed to scan and email forms to community care License.

The following information was requested from file

In addition to gathering the necessary documents, LPA's also discussed the events of the incident with the administrator to better understand the timeline of the reported death. Valerie was at the hospital at the time of death and a coroner's report number provided.