Facility Evaluation Report
Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced case management visit regarding an incident report, regarding a death report for a resident referred to as R1. LPA met with Administrator Rosalie B Zbasnik-Hulog and explained the purpose of the visit.
On March 4, 2026, the Department received an incident report stating on March 3, 2026, stating resident R1 had passed away. The incident report stated on March 3, 2026 at 6:10pm, Wellness staff received a phone call from R1's family member, stating he/she has been calling R1, but no answer. Wellness staff went to the room and found R1 unresponsive.
LPA requested R1's Identification and Emergency Information, house keeping schedule, physician's report, pre admission appraisal, medication list.
LPA requested a copy of resident R1's death certificate once it becomes available.
At this time, this case in under review and Department will conduct a follow visit , if warranted.
No deficiencies cited during today's visit. This report was reviewed with Administrator Rosalie B Zbasnik-Hulog and a copy of the report was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction