Facility Evaluation Report

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Case Management visit to follow up on a resident death reported to Community Care Licensing. LPA was welcomed by, identified herself to, and discussed the purpose of the visit to Sydney Recce, Business Office Director.

Community Care Licensing received a Death Report on 4/22/26 in which it was reported that Resident #1 (R1) had passed away on 4/19/26 at the facility, following a hospitalization from a fall at the facility on 4/15/26. Per the report, R1 had an unwitnessed fall and was found by care staff and promptly called for emergency services. Per th e report, R1 sustained a laceration to bridge of nose and forehead which required stitches in addition to needing a blood transfusion. Upon being discharged back to the facility, R1 was admitted to hospice services. [See LIC811 Confidential Name List for a description of select person identifiers used in this report.]

During today's visit, LPA conducted a file review. The facility is currently awaiting the death certificate and will forward to the Department once received. Per LPA file review and interviews, the facility responded appropriately by arranging for prompt medical attention for R1 upon notification of incident.

At this time, LPA observed no immediate health 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 based on additional information from the Death Certificate once obtained. An exit interview was conducted with Sydney Recce, Business Office Director to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.