Facility Evaluation Report

Licensing Program Analysts (LPA) Bernadette Allen conducted an unannounced visit to the facility to conduct a case management visit and follow up on an adult client death. LPA Allen met with Irene Capili who was informed of the purpose of the visit.

This case management visit consisted of collecting pertinent documentation and conducting staff and residents interviews regarding the death of Client #1(C1). LPA Allen interviewed the administrator, client #2 (C2) and client #3 (C3) for further information regarding the death of (C1) and the events that led up to (C1's) death.

Irene Capili stated that there is no official death certificate or cause of death at this time. LPA Allen has advised the administrator to send a copy of the death certificate to Community Care Licensing Division (CCLD) Riverside Regional Office as soon as it is available.

LPA toured the facility inside and out and there was no imminent health and/or safety concerns observed at the time of visit

An exit interview was conducted where this report was discussed with Irene Capili and a copy was provided at the conclusion of the visit. .