1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 | Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct a case management - incident visit to follow-up on an incident and death report received for resident (R1). LPA met with Administrator, Lilian Bufi.
On 03/05/2024, the Department received a death report for resident (R1). On the morning of 02/27/2024 around 5:00am, NOC shift staff observed R1 laying on the hallway floor unconscious with a pulse and an injury to his/her forehead. Staff immediately called 911 and R1 was transported to the hospital. During today's visit, LPA interviewed the Administrator. Based on interview, the facility's awake NOC shift staff conducted a bed check around 5:00am and observed R1 sleeping. About 5-10 minutes after the bed check, staff found R1 laying in the hallway unconscious. R1 was able to ambulate without assistance. On the same day, ADM visited the hospital and was informed by the doctor that R1 suffered from cardiac arrest. On 03/02/2024, R1 passed away in the hospital.
On 03/05/2024, LPA Simi Rai contacted the facility and spoke with the Administrator to request for R1's death certificate. During today's visit, LPA Dolores reminded ADM of the request for R1's death certificate. ADM stated understanding.
Documents obtained and reviewed to include R1's physician's report, IPP, medical records, identification and emergency information, functional capabilities, resident roster, and LIC500.
No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Administrator, Lilian Bufi and a copy of the report was provided. |