Facility Evaluation Report
Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management - Incident visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Memory Care Senior Residential Support Manager Gerardo Godinez and Resident Support Manager Salvador Anton.
Today's visit was in response to two (2) LIC624A Death Reports, which licensee self-submitted to the CCLD San Diego Regional Office (RO). The first LIC624A (received on 06/23/2023) described Client #1 (C1) passing away on 06/23/2023. The second LIC624A (received on 07/06/2023) described Client #2 (C2) passing away on 07/05/2023. [See LIC 811 Confidential Names List for a description of the person identifiers used in this report].
During today’s visit, LPA performed a brief facility tour / welfare check on remaining clients, finding no safety concerns. LPA also collected copies of pertinent records and interviewed relevant staff.
According to records and interviews: C1 was diagnosed with Alzheimer's Disease starting in 2010, and C2 was diagnosed with Alzheimer's Disease starting in 2016. Both C1 and C2 were under the care of hospice agencies when they each passed away.
No deficiencies were cited for the deaths of C1 or C2. Also, no deficiencies were observed or cited during today's visit.
An exit interview was conducted with Anton, to whom a copy of this report, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction