Facility Evaluation Report

Purpose of Visit: Incident Follow-Up – Death of Resident

Licensing Program Analyst (LPA) Renita Hall conducted an unannounced case management visit to follow up on an incident reported to Community Care Licensing. LPA met with the Executive Director and the Director of Resident Care and discussed the purpose of the visit.

This report documents the follow-up related to the death of Resident 1 (R1). A review of records indicates that R1 was assessed on 03/26/2025 and determined to be independent and not requiring assistance.

A Physician’s Report dated 04/25/2025 documented that R1 was 89 years old with a diagnosis of Atrial Fibrillation (A-Fib). The report noted no physical or mental health limitations, no diagnosis of dementia, and that R1 was able to communicate needs, follow instructions, self-administer medications, ambulate independently, and transfer independently. R1 was able to leave the community unassisted and was in good physical health.