Facility Evaluation Report

Licensing Program Analyst (LPA) Michelle Echeverria made an unannounced visit to the facility. LPA arrived at the facility to conduct a case management visit to follow up on a client's death. LPA met with Staff Jasmine Scott and explained the purpose of the visit. Administrator Regina Scott later arrived and was informed of the purpose of the visit.

The case management visit consisted of a walk through of the facility, collection of client documents and interviews regarding the events which led to the client's death. LPA interviewed the Administrator for further information regarding the death of C1 and the events that led up to C1's death. Administrator stated that no official death certificate has been received at this time, yet she was informed by the hospital about the preliminary cause of death. LPA has advised the Administrator to send a copy of the death certificate to the Community Care Licensing Division (Department) Riverside Regional Office as soon as it is available. LPA spoke to C1’s conservator on the telephone during today’s visit, LPA was provided the cause of death based on what they were told by the hospital and what was printed on the death certificate. LPA informed C1's conservator to provide a copy of the death certificate via email to LPA.

During record review, LPA observed missing incident reports. Deficiency issued.

Deficiency was cited during this visit. An exit interview was conducted where this report LIC 809, LIC809D and appeal rights were discussed and provided to Administrator Regina Scott.