Follow-up·May 10, 2023

Licensing Program Analyst (LPA) Javier Prieto arrived to the facility for a case management visit related to the passing of an adult resident (R1), who passes away on 04/29/2023. LPA Prieto met with Executive Director Jennifer Heldoorn and RSD Isabel Enriquez. LPA explained the purpose of the visit and gathered pertinent information related to R1s passing. LPA was provided with R1's ID/Emergency Information, Admission's Agreement, Physician's Report, Resident Appraisal, Needs and Services Plan, Progress Notes, Medication Records, Incident reports and a 30 day Notice from the family of R1. R1 was visited by a family nearly everyday of R1's stay at the facility. Interviews and documentation will show that R1 last left the facility on 04/17/2023 for a routine Doctor's appoint. R1 was seen by PCP and later transferred to Loma Linda Medical Hospital under doctor's supervision. A 30 day Notice was given to Business Office Manager Michelle Sosa on 04/28/2023, indicating R1 is has a previous terminal illness and may pass under medical care. R1 passed at the medical facility, with facility and per a family directive. LPA Prieto concluded interview with facility staff. LPA Prieto and Executive Director Jennifer Heldoom both signed this report and a copy was left with the facility.