Incident investigation·December 2, 2021

Licensing Program Manager (LPM) John Rante and Licensing Program Analyst (LPA) Kayla Hilario, conducted an unannounced Case Management Visit. LPM and LPA met with Executive Director John Brennan, and we discussed the purpose of the visit. Today's visit is in response to the self-reported death of Resident 1 (R1 - see LIC811 Confidential Names List). R1 passed away at the facility, date of death: 11/26/2021. LPM and LPA conducted a wellness check at the facility, and no health or safety issues were identified. Residents observed appeared appropriate for the facility. Additional information was obtained on this date regarding R1's death. No deficiencies were cited or observed on this date. An exit interview was conducted. The Licensee will be provided a copy of their appeal rights (LIC9056 01/16), via email, along with a copy of this report. An electronic read receipt will serve as confirmation of receipt of documents.