Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced Case Management – Incident visit for the purpose of investigating self-reported incident report. Upon arrival LPA met with Administrator and explained the reason for the visit.

On 09/15/2025, the Regional Office received a self-reported incident report which stated, Staff #1 (S1) brought Client #1 (C1) to the bathroom around 4pm. On the way back to the living room, C1 vomited and collapsed right outside the hallway/front door area, 4:03pm. S1 thought C1 needed fresh air. S1 carried C1 outside the backyard. Another staff got new clothes for C1 to take C1 to the emergency room. C1 vomited four more times with visible traces of blood. 4:06pm, 911 was called and co-admin Amelia Banas was alerted. At approximately 4:11pm, emergency medical technicians (EMT) arrived and provided resuscitation efforts for C1 until about 4:40pm. EMT told Amelia and Lorenzo that the hospital had told them to stop their efforts since C1 was unresponsive. Local law enforcement arrived, contacted the county examiner and took some pictures. County examiner arrived at approx 7pm, and took pictures of the backyard and C1's room. Examiner then took down information about C1's parents and said they would need to perform an autopsy to determine the cause of death and would alert the family.

At approx 10:00am. LPA conducted physical plant, interviewed staff, and reviewed and obtained copies of pertinent documentation relevant to the incident.

Based on interviews and records review no immediate or potential health and safety concerns were observed during the visit and no deficiencies cited at this time. LPA has determined should further investigation be warranted, LPA will return at a later date.

Exit interview conducted and copy of the report was issued.