Incident investigation·September 10, 2021

Licensing Program Analyst (LPA), Alexandre Vo, conducted a case management visit regarding a death reported to the San Diego Regional Office on September 9, 2021. LPA was allowed entry into the facility after identifying himself and stating the purpose of the visit. On September 1, 2021, resident #1 (R1, see list of confidential names) had a medical accident and was sent to the hospital after staff attempted life-saving measures. On September 8, 2021, facility was notified by Telecare, Case Manager, that resident expired at a local hospital. LPA briefly interviewed staff to establish a timeline and collected pertinent records. At this time, additional information is required to complete the investigation. No deficiencies were cited during this visit. An exit interview was conducted and a copy of this report and Licensee's Rights (9058 01/16) were provided to the Administrator, whose signature on this form confirms receipt of these documents.