Facility Evaluation Report

Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced Case Management – Incident visit to the above facility. The LPA met with staff and explained the reason for the visit. Administrator Lailani Macasias arrived shortly thereafter.

The reason for today's inspection is to follow up on a self-reported incident report received on 05/16/2024. The report pertains to an incident involving Client#1 (C1). It was reported that on 5/15/24, C1 approached staff saying they were having a headache, and after a few minutes C1 started throwing up. It was further reported that C1 became unresponsive and was sent to the hospital. C1 passed away on 5/16/24 at the hospital due to a brain bleed. Per the information received, the circumstances surrounding the death of Client #1 on 05/16/2024 may be questionable and needs to be investigated.

During today's visit, the LPA conducted an interview with the administrator throughout the visit, a brief tour of the facility and obtained copies of pertinent documents.

This incident was referred to Community Care Licensing Investigations Branch (IB) for review. Further investigation is required. An investigator or the LPA will return at a later date.

Exit interview conducted. A copy of the report was issued to the Administrator Lailani.