Facility Evaluation Report

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced Case Management regarding a death report received at the regional office on 04/25/2022. LPA met with and was granted entry by Administrator, Maria Dineros, who was informed of the purpose of the visit. At the time of the visit there were 4 residents, and 7 staff members present.

LPA requested and received the following documents:

· ID and Emergency Information (LIC 624A)

· Updates and Prior Individual Health Care Plan (IHCP)

· Incident reports leading up to the death

Most Recent Physician's report was not at the facility and Administrator was advised to e-mail as soon as possible.

LPA provided a copy of this report to Administrator, Maria Dineros