Facility Evaluation Report

Licensing Program Analyst (LPA) Armando Perez made an unannounced visit to conduct a case management visit to follow up on a client's death. LPA met with Licensee Aimee Cabiling (S1) and explained the purpose of today's visit. LPA was informed that Client#1(C1) was last seen at the facility on December 15, 2024 and was missing until he was found sitting unresponsive in his room on the morning of December 17, 2024.

During the visit LPA reviewed and collected pertinent documentation such as: ID/Emergency information, Admission Agreement, Physicians report, Medication records, service plan, as well as conducted staff interviews in regards to the death of C1. LPA interviewed Licensee Aimee Cabiling, Staff (S2) and client 2 (C2) for further information in regards to the death of C1 and the events that led up to C1's death. C1's medications were reviewed, LPA observed MAR records are not available or utilized at the facility.

LPA inquired about the cause of the death. A death certificate has not been issued at this time. Additionally, the preliminary cause of death is still being determined. LPA advised to send a copy of the death certificate to the regional office once received.

Licensee did not contact Community Care Licensing until a faxed Incident report and death report was submitted on December 23, 2024. LPA informed Licensee to reiterate the time frame requirements and the importance of communicating in a timely manner to avoid deficiencies.

An exit interview was conducted, a copy of this report was provided to Licensee Aimee Cabiling. .