Facility Evaluation Report

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Case Management visit to follow up on a client death reported to Community Care Licensing. LPA was welcomed by, identified herself to, and discussed the purpose of the visit to Fe Martinez, Assistant Administrator. LPA also spoke with Administrator Cyra Mabalot over the phone.

Community Care Licensing received a Death Report on 12/26/25 in which it was reported that a Client (identified as C1) had passed away on 12/26/25 at the facility, with cause of death unknown.

During today's visit, LPA conducted file review, interviews, and observed clients in care. The facility is currently awaiting the death certificate once cause of death is officially determined and will forward to the Department once received.

At this time, LPA observed no immediate health and/or safety concerns and no deficiencies were cited during today's visit. Additional visits and follow-up may be necessary for complete review of this incident.

An exit interview was conducted with Fe Martinez, Assistant Administrator to whom a copy of this report and the Licensee/Appeal Rights (LIC9058) were provided. Signature below confirms receipt of these documents.