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 Nursing Home Administrator (NHA) Sangeetha Narasimhan and explained the purpose of the visit.
On April 11, 2025, the Department received an incident report stating on April 9, 2025, which stated resident R1 had passed away. The incident report stated R2 had left R1 in the bedroom, while R1 was taking a nap at 12:45pm. R2 returned and went straight to the couch and rested for 15 minutes. R2 then went to check on R1 and saw that R1 had passed away. The cause of death is unknown at this time.
LPA requested R1's , R1's Identification and Emergency Information, house keeping schedule, admission record, physician's report, pre admission appraisal, medication list. LPA also requested a copy of R2's physicians report and pre admission appraisal.
LPA requested a copy of resident R1's death certificate once it becomes available.
LPAs determined this case management needs further investigation.
No deficiencies cited during today's visit. This report was reviewed with Nursing home Administrator Sangeetha Narasimhan and a copy of the report was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction