Facility Evaluation Report

Licensing Program Analyst (LPA) Esther Cortez conducted a subsequent case management visit to deliver findings for questionable death investigation initiated on 05/21/2024 case management visit. LPA met with assistant administrator, Happy Nguen and explained the reason for the visit. Administrator Lailani Macasias was contacted via phone and the reason for the visit was explained. Administrator was unable to be at the facility during today’s visit and authorized Happy Nguen to sign and receive the report.

On 05/20/2024, the Woodland Hills Adult and Senior Care Regional Office (RO) received an incident report regarding a neglect/lack of care and supervision allegation. Client #1 (C1) sustained a brain bleed while in care of the facility and subsequently expired at the hospital. The case was referred to the Community Care Licensing Division (CCLD) Investigations Branch (IB) and assigned to Investigator Sonia Sandoval.

On 05/21/2024, from 12:50pm to 3:45pm, Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced Case Management – Incident visit to the above facility. LPA Cortez met with staff and explained the reason for the visit. Administrator Lailani Macasias arrived shortly thereafter. The reason for the visit was to follow up on a self-reported incident report received on 05/16/2024. The report pertained to an incident involving Client#1 (C1). It was reported that on 05/15/2024, 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 05/16/2024 at the hospital due to a brain bleed. Per the information received, the circumstances surrounding the death of C1 on 05/16/2024 may be questionable and needed to be investigated. During the visit, the LPA conducted an interview with the administrator, conducted a brief tour of the facility and obtained copies of pertinent documents. The incident was referred to Community Care Licensing Division (CCLD) Investigations Branch (IB) for review. The LPA determined further investigation was required prior to issuing findings.

Report will continue on LIC809-C (2nd page).