Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced case management visit and met with House Manager Natividad Barbadillo (HM)

Today's visit is to follow up with the case management visit on 08/04/2025. .

On 07/23/2025, resident R1 came back from day program in the afternoon and had a fall. R1 was sent to hospital.

On 07/30/2025, at 07:37PM, R1 passed away in the hospital.

On 08/04/2025, the Department conducted an unannounced case management visit at the facility.

On 09/29/2025, LPA received R1's death certificate.

Based on the review of R1's death certificate dated 09/05/2025, R1's cause of death is heart disease.

Based on the interview conducted and records reviewed, there is no suspicion of R1's death at this time.

Exit interview was conducted with HM. The report was provided to HM for review and signature. A copy of the report was provide to HM.