Facility Evaluation Report

Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced Case Management - Incident inspection at the facility today. Tri-Counties Regional Center Quality Assurance Specialist (QAS) Liz Aced-Arnett was also present. Co-Administrator Ryan Carino was at the home when the LPA and QAS arrived.

Today's inspection is a follow up to the 11/16/2021 Case Management - Incident visit regarding the self reported death report received on 11/15/2021 pertaining to Resident #1 (R1) who passed away on 11/14/2021. During today's inspection, the LPA and QAS conducted an interview with Co-Administrator Ryan Carino and Staff #1 (S1) beginning at 10:02 AM.

Further investigation is needed. Exit interview and report reviewed with Ryan Carino. A copy of the report will be emailed.