Facility Evaluation Report

Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced case management visit to investigate a client death. LPA identified herself to, was allowed entry by, and explained the purpose of the visit to Staff Sergio Catalya. Administrator Grace Cosico and Facility Manager Reginald Cosico arrived during the visit.

On 12/11/2025, the Department received a death report reporting Client 1’s death, which occurred on 12/9/2025. [LPA provided Administrator with an LIC811 Confidential Names List to identify C1] During today’s visit, LPA conducted a health and safety check, observed clients in care, reviewed facility records, and interviewed staff. LPA requested C1's death certificate when it became available.

No deficiencies were cited on today’s date. An exit interview was conducted with Administrator Grace Cosico and Facility Manager Reginald Cosico, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).