complaint·August 31, 2022

During the 10-complaint visit, LPA Hamilton conducted inspection and noted that while touring R1's former bathroom, LPA observed some discoloration within the medicine cabinet as well as the tile grout near the base of the toilet. LPA observed a section of the wall directly behind the toilet was uneven. S1 stated the area was worked on 3 years ago to repair a leak. LPA Delmundo conducted inspection on this day, August 31, 2022, with Lulin Wu. LPA randomly selected 6 residents' rooms and toilets/showers for inspection. LPA observed the following in 5 of 6 rooms: missing baseboards in 2 rooms; part of flooring chipped; rusted bathroom lavatories; grab bar missing in the shower room; peeled bathroom door paint Based on observation, the allegation is substantiated. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiency is cited from Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction by plan of correction due date and any repeat violation within 12 month period may result in civil penalty. Deficiency and plan and proof of correction were discussed with Lulin Wu. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided. Allegation: Facility is unsanitary. It was alleged that R1's room was unsanitary; there were cobwebs on the walls above R1's head, dried blood on R1's bed sheet and the bottom of the dresser was filthy. R1's family member (FM) was interviewed and stated that R1's room was unsanitary. When FM picked-up R1's belongings after R1 passed away, R1's hat was covered with mold. LPA Hamilton noted during his 10-day complaint visit that there's no obvious signs of unsanitary conditions. On this day, August 31, 2022, LPA Delmundo conducted inspection with Lulin Wu. LPA inspected the common areas, randomly selected 6 residents' room and bathrooms/shower, kitchen, dining area and storage. LPA did not observed any cobwebs and mold, nor facility being unsanitary. LPA interviewed S2 and S3 who both indicated that when R1 passed away, they packed R1's belongings and put them in boxes and bag and stored them in the storage until FM picked them up. They did not inspect the boxes and bag prior to handling them over to FM about a month after R1's death. LPA tried to interview R1's room mate who refused to be interviewed. Allegation: Facility staff did not provide to resident's responsible party resident's (R1) personal belongings. It was alleged that when R1's belongings were picked-up after R1's death, the wheelchair and walker were not given and photograph of R1's family member was not included with R1's belongings. LPAs Hamilton and Delmundo conducted interviews and obtained copies of LIC621, Staff S2 and S3 stated that when FM came to the facility to pick-up R1's belongings, they assisted FM in loading the items in FM's vehicle including the wheelchair and walker. S2 indicated she did not see the picture FM indicated missing when they packed-up R1's belongings. LPA reviewed the LIC621 which revealed the items which were allegedly missing were not listed. Based on the information obtained, the allegations are deemed unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No deficiency cited. Exit interview conducted and copy of this report provided.