Facility Evaluation Report

Licensing Program Analyst (LPA) Kennedy conducted a case management visit to complete a review regarding a self-reported death of Client 1 (C1) (See LIC 811 for confidential names) received by CCL on 11-17-21. LPA met with Gerardo Godinez, Senior House Manager and discussed the purpose of the visit.

LPA reviewed C1's facility file and hospice care notebook, and interviewed staff about events leading up to death. C1 resided at the facility since 2017 and was admitted to hospice on 8-30-21. The hospice agency provided comfort measures, facility staff training and health monitoring to C1 through the end of C1's life. The death of C1's was expected.

No deficiencies were cited during the visit.

An exit interview was conducted with Gerardo Godinez. A copy of this report along with Licensee Rights (LIC9058 01/2016) was provided to the facility via email. An electronic response confirms the documents were received.