Facility Evaluation Report

Licensing Program Analysts (LPA) Bruce Jacobs arrived at the facility to follow up of on an incident report that was submitted by the facility to Licensing. The incident report was on the death of client (C-1) who passed at the hospital. LPA met with Facility Administrator Darrell Gapasin as well as the care staff. LPA discussed the incident.

LPAs conducted additional interviews with facility staff, management and reviewed client file. Copies of file documents obtained. The client complained of pain on 2/16/22 and the facility called the client's Physician who advised the facility to take the client to be seen at the hospital. Client was taken to the hospital and was treated for sepsis. On March 17th the client was placed on hospice while still in the hospital and given comfort care and passed on 3/21/22 at the hospital

At this time, this case management information will be reviewed with the Licensing office

Exit interview conducted with the Administrator. Copy of this report provided.