Facility Evaluation Report

Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility 03/25/2022 at 10:00 AM to follow up on a Death Report regarding Resident 1 (R1) death at the facility. LPA Brown identified herself to Administrator Michael Garcia, who was also advised of the purpose of the visit.

On 03/22/2022 Community Care Licensing Department (CCLD) was notified of the death of Resident 1 (R1) last 03/21/2022. LPA Brownrequested the following documents:

LPA Brown also requested additional documentation be sent to CCLD; such as, the Coroner's Report, Police Report, and a Death Certificate upon availability.

An exit interview was conducted where this report (LIC809) was discussed, and a copy was provided to the Administrator Michael Garcia at the conclusion of the visit.