Facility Evaluation Report

Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced Case Management Incident visit. LPA was greeted and granted entry by Licensee Julita Ramirez. LPA explained the purpose of the visit and toured the facility. The visit is in response to the death of Client One (C1), whom passed away on 10/03/2023.

During LPA's visit, LPA reviewed C1's file and obtained copies of the following: ID/emergency Information, admission agreement, Physician's reports, Psychiatric notes, Functional Capabilities Assessment, Individual Program Plan, progress notes, and medication records (MARs) for the last 30 days. LPA also requested a copy of C1s death certificate when it is made available.

During today's visit no deficiencies were cited in regard to this incident.

An exit interview was conducted, and a copy of this report was provided to Licensee Julita Ramirez along with a copy of the LIC 811.