Incident investigation·December 13, 2021

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced case management visit to follow up on a incident report submitted to Community Care Licensing on 12/09/2021. LPA was greeted and granted entry into the facility by Caregiver Paulo Faeldo and explained the reason for the visit. Incident report dated 12/09/2021 indicated that Client 1 (C1) had passed away at Anaheim Medical Center on 12/07/2021. Interview conducted with Caregiver Faeldo indicated C1 had been sent to the hospital after coughing and having blood oxygenation levels in the low 70's. The client was having difficulty breathing and caregiver was in consultation with C1's primary care physician. Client had a "Do Not Resuscitate" on file. Family member advised facility that client had passed while at the hospital. Facility to request a copy of the death certificate from family and forward to LPA. Per physician report dated 06/09/2021, Client was diagnosed with Dementia. Client admitted into the facility in August 2021 after a prior hospitalization. The investigation remains ongoing. Exit interview conducted and a copy of this report was left at the facility.