Facility Evaluation Report

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted a case management visit to complete a review regarding a self-reported death of Resident 1 (R1) (See LIC 811 for confidential names) received by CCL on 3/3/2023. LPA met with Executive Director, Disha Hall.

LPA reviewed R1's facility file, toured the facility, and conducted interviews with staff about events leading up to the death. R1 resided at the facility since 7/26/2022. On 3/1/2023, at 10:48 p.m. R1 passed away at the facility, unknown cause of death. During the case management visit LPA reviewed R1's relevant records. LPA requested the death certificate.

No deficiencies were cited during the visit.

An exit interview was conducted with Resident Services Director, River Jon Pagala, to whom a copy of this report and the Licensee Rights (LIC9058 01/2016) were provided at the conclusion of the visit.