complaint·September 4, 2024

Page 2 One of the staff stated not working on the day the incident happened while the other one indicated not working on the same shift S1 worked. One of the four staff stated R1 told her about S1 telling R1 she's heavy. ADM stated S1 told her that she (S1) told R1 to help out in getting up from the bathing chair because she's heavy. Based in interviews conducted, the preponderance of evidence has been met, therefore the allegation is found to be substantiated. Deficiency is cited from Title 22 California Code of Regulations, and listed on 9099D. A $250.00 civil penalty is assessed for repeat violation within 12 month of section 1569.269(a)(1). Failure to submit proof of correction by plan of correction due date may result in additional civil penalty. Deficiency, plan and proof of correction, and civil penalty were discussed with ADM. Exit interview conducted. Appeal Rights, LIC421FC Civil Penalty Assessment, LIC9098 Proof of Correction form and copy of this report provided. Page 2 Allegation: Staff do not answer resident's (R1) request. R1 indicated she requested the staff to move the wheelchair away from the door and staff did not answer the request. All the staff interviewed indicated not observing wheelchair blocking the door nor R1 requesting to remove the wheelchair. R2 and R3 stated not observing a wheelchair blocking the door. Allegation: Staff does not ensure resident (R1) is accorded privacy. R1 indicated she needed to use the bathroom and was not accorded privacy. One of the staff interviewed stated she was to give R1 eye drops and looked for R1 by calling her who was at the time was in the bathroom. The other staff indicated there are times when R2 will knock when R1 is in the bathroom to check first if someone is inside and that there's another toilet but these 2 residents prefer to use the big bathroom. The other residents interviewed stated being accorded privacy and staff are respectful. Allegation: Staff does not provide adequate food service. It was alleged that R1 had diarrhea for several days and was told by a nurse that it's due to the food. R1 was interviewed who stated she's having diarrhea for days and her doctor told her it's because of the abscess tooth and that she was referred to the dentist. Copy of documents obtained by LPA showed R1 is prescribed anti-biotics. The other 2 residents interviewed stated food serve is always good. All the staff interviewed indicated not serving stale food. LPA conducted inspection and didn't observe any expired food. Based on information gathered, the above allegations are closed as unsubstantiated. A finding that a complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. No deficiency cited. Exit interview conducted and copy of this report provided.