Facility Evaluation Report

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced case management visit regarding an incident report. LPA met with Administrator Julius Canonizado and explained the purpose of the visit.

On July 15, 2025, the Department received an incident report regarding resident R1. The incident report stated, On July 11, 2025 at 7:30am R1 woke up and went to the bathroom and locked the door like he/she normally does. At 7:50 staff knocked on the bathroom door to check on him/her. R1 didn’t respond to any door knocking. Then staff opened the door and found R1 on the floor unresponsive. One of the care staff did CPR on R1 while the other staff called 911. At 8:05 the fire department showed up and carried R1 to the living room and continued doing CPR on him/her. At 8:20am R1 had passed away. Staff stated R1 was in good mood all week and everything seemed to be normal this week.

On July 16, 2025, LPA Monter conducted an unannounced case management visit to request documents pertaining to resident R1.

LPA requested R1's Progress Notes , R1's Identification and Emergency Information, San Andrea's Regional Center(SARC) schedule, Appraisal needs and services plan, SARC IPP reports, R1's Behavioral consult/ Quarterly Report, LIC500.

Exit interview was conducted with Administrator Julius Canonizado . A copy of this report was provided.