complaint·December 6, 2024

Continued from LIC9099. submitted to CCLD, which indicated R1 had complained of pain to his arm to his family member on 3/18/2022, where R1 slid from his chair onto the floor. Per incident report R1 stated the incident occurred two weeks prior. R1 also stated at the time of the incident he refused help from the two (2) staff that came to assist. S1 stated during interview that protocol is for staff to inform the director of the incident in a timely manner. Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of the appeal rights and this report provided. Continued from LIC9099. and fell when trying to independently transfer from bed to wheelchair. Review of Kaiser of San Leandro medical records dated 3/19/2022, indicated R1 sustained a fracture to his right humerus bone while transferring from his wheelchair to his bed. At the time of admittance to the facility and at the time of the injury, R1 was independent and able to transfer between his bed and wheelchair. Based on record review, R1 was listed as ‘independent’ and did not require transfer assistance from and to bed from the wheelchair. Allegation: Staff did not ensure that resident was adequately fed W1 stated that R1 was able to wheel himself around but didn’t want to. R1 wanted staff to wheel him downstairs to the dining area. W1 stated there were times that staff would come to assist R1, but it was too early for R1 to eat. Department reviewed charting notes from facility that indicated R1 refused dinner several times due to R1 had food or snacks in his room. Per R1's assessment R1 required reminders for meals not to be escorted. Allegation: Staff did not provide resident showers according to the resident's Admission Agreement Based on interview with W1 showers were to be given to R1 Friday’s at 1pm and R1 would refuse if showers were not timely. W1 stated the facility was aware of this before R1’s admission. Review of admission agreement indicated facility will provide assistance with bathing. Review of R1's assessment dated 11/29/2021 indicated R1 required a one (1) person assist per week for bathing. Department did not Continued on LIC9099C. Continued from LIC9099C. observe any documentation that was agreed upon between R1's responsible party and the facility that showers will be given at a specific time. Per S1 staff would try to accommodate R1's request for the time of shower but it was not always possible due to assisting other residents. All egation: Staff did not keep resident's room clean or sanitary Based on initial interview with W1 staff did not keep resident’s room clean or sanitary. During interview with W1 on 12/2/2024, W1 stated there was not an issue with R1’s room being cleaned. W1 saw the housekeeper a few times while visiting. Allegation: Facility call system was not accessible to resident Based on interview with W1 the call pendent R1 was given was usually broken. W1 stated when the pendent wasn't working staff would come and take it, but wouldn't get it replaced for a couple of days. During interview with S1 if a pendent was not working or low battery the system will notify staff and a new pendent will be give. S1 stated the pendents can not be fixed. The facility keeps pendents available. S1 pulled a call log from the archives dated 3/13/2022 - 3/31/2022, which divulged R1 had used pendent six (6) times during that period. The dates the pendent was used was 3/13, 3/14 (2xs), 3/16, 3/17, and 3/18. Based upon the interviews conducted and information obtained during investigation. The above allegations are unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Exit interview conducted and a copy of report was given .