Follow-up·July 26, 2022

Licensing Program Analyst (LPA) Alma Gonzalez conducted a case management visit to follow-up on the death of Resident 1 (R1). LPA met with Assistant Administrator Anna Rempel and explained the reason for the visit. LPA interviewed Assistant Administrator Anna Rempel. According to the incident report dated 7/22/22, R1 passed away on 7/22/22. Per Assistant Administrator the suspected cause of death was stated by paramedics as natural causes. R1 was seen outside of the facility by a staff member who reported to Assistant Administrator that R1 was seen unresponsive down the street away from the facility and Assistant Administrator Rempel immediately called 911. Assistant Administrator contacted all applicable agencies to report the incident/ death. Police Department did not leave a police report number. During today's visit, LPA interviewed Assistant Administrator Rempel and reviewed R1's file. LPA requested copies of the following documents: · Physician's Report For Residential Care Facilities For The Elderly (RCFE) dated 2/17/21 · Appraisal/ Needs and Services Plan · Medication Sheet dated for July 2022 · Identification and Emergency Information · Preplacement Appraisal Information · Resident Appraisal Assistant Administrator was asked to provide a copy of R1's death certificate when it becomes available. Exit interview conducted and copy of Report was provided to Assistant Administrator Anna Rempel.