Incident investigation·March 24, 2022

On 3/24/22 Licensing Program Analyst (LPA) Martessa Brown conducted a Case Management Visit. LPA met with Susan Sungnam Park and explained the purpose of todays visit. On 03/25/21 the facility faxed a Death Report regarding Resident (R1) passed away on 3/25/21. On 4/5/21 LPA Brown met with the administrator and conducted a health and safety check of residents in care. LPA interviewed the administrator and requested the following documents: R1's entire file, food menu and emergency procedure. On 3/24/22 LPA Brown toured the physical plant with the administrator. LPA Brown obtained a copy of R1’s Death Certificate and the cause of death was Cardiopulomary Arrest and other health issue. This case has been closed and no follow-up is needed. An exit interview was conducted with Taehee Lee, RN.