Facility Evaluation Report
Licensing Program Analyst (LPA) Steve Chang conducted an unannounced Case Management - Incident visit and met with Administrator (ADM) Shantela Yadao.
On 11/06/2023, LPA Chang interviewed staff S1- who stated that Resident (R1) was found on the floor of R1's bedroom on 11/3/2023 at 7:00AM in Assisted Living found by staff (S2).
911 was called immediately, around 7:15AM on 11/3/2023. R1 was assessed by paramedics, R1 was pronounced dead at 7:25AM.
LPA interviewed 4 Staff (S1 - S4) and Administrator (ADM). LPA interviewed two Family members (FM1, FM2) of resident (R1).
LPA obtained R1's Physician Report, Medication list and Care Plan and notes.
4 Out of 4 staff stated that R1 was weak due to cancer and was on oxygen 24 hours due to short of breath.
ADM stated that R1 was seen on 11/3/02023 at 4:50AM by a NOC shift staff (S5) in his/her bedroom and was fine. On 11/3/2023, at 7:00AM, R1 was found on the floor unresponsive of his/her bedroom.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction