Facility Evaluation Report

Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management visit. LPA identified herself and was granted entry by the Receptionist. LPA met with Gerardo Godinez, Senior Residential Support Manager and Carly McKim, Residential Support Manager and discussed the purpose of the visit.

On October 24, 2022, the facility self reported a resident death regarding Resident 1 (R1) (See LIC 811 Confidential Names List) to Community Care Licensing. This visit was conducted to follow-up with the death report.

During today’s visit, LPA briefly toured the facility, conducted interviews with Gerardo Godinez, Senior Residential Support Manager and Carly McKim, Residential Support Manager, requested and obtained relevant records. This case management visit requires further follow-up and a copy of the resident's death certificate was requested upon receipt. No deficiencies were cited during today’s visit.

An exit interview was conducted with Gerardo Godinez, Senior Residential Support Manager and Carly McKim, Residential Support Manager and a copy of this report, LIC 811 and Licensee/Appeal Rights (LIC 9058 01/16) were provided to both Managers at the conclusion of the visit.