Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct a case management - incident visit. LPA met with General Manager, Kippie Castronovo.

During today's visit, LPA was verbally informed of a resident (R1's) death on 05/25/2024.

Based on record review and interview, the facility did not notify the Department of R1's death within 24 hours of the occurrence date.

R1's documents were requested by tomorrow (05/30/2024) morning: physician's report, needs and services plan, identification and emergency information, and progress notes for May 2024.

Documents were obtained during visit to include the incident report, police case number, and coroner's case number.

This case management visit will be pending investigation.

A deficiency was cited per California Code of Regulations, Title 22. See LIC809-D.

This report was reviewed with General Manager, Kippie Castronovo and a copy of the report and appeal was provided.