Facility Evaluation Report

Licensing Program Analyst (LPA), Natasha Persaud conducted a Case Management - Incident visit. LPA discussed the purpose of the visit with Program Administrator, Melissa Martinez.

On 01/28/25, the facility's Program Administrator self reported a client death. The facility reported Client #1 (C1) left the facility on 01/27/25. The facility conducted a search, notified local law enforcement, and notified the client's responsible party. C1's Physician Report dated 10/23/24 indicated C1 can leave the facility unassisted. C1 passed away on 01/27/25.

Today, the facility was briefly toured, records requested and interviews conducted with staff. No deficiencies were issued today. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Program Administrator, Melissa Martinez whose signature below confirms receipt of these rights. [See LIC 811 Confidential Names List to identify Client #1].