complaint·June 11, 2025

...continued from LIC9099. Allegations: SUBSTANTIATED Staff are not ensuring that resident(s) receive their medication's as necessary. S6 reported on R1’s progress notes dated 03/15/2025 that R1 last received Sertraline on 03/12/25; The Electronic Medication Administration Records (EMAR) further reports that Omnicare and Elegance Berkeley had two different attending physicians. As a result, W1 wrote a prescription on 03/17/25 and W2 provided the medication to the facility for R1. S6 stated that the R4’s medication was discontinued on 02/28/25, but R4 missed the medication for two days, R4’s family was not notified, and the doctors were not aware. S6 states, “Staff are not properly trained.” Staff are not adequately supervising resident(s) in care. On 03/04/25, S8 documented on R1’s progress notes that R1 was found outside by the corner of the facility. Records and interviews with S1, S2, S5, S6, S7 and W2 revealed that R1 has exited Memory Care and had wandering behaviors in March and April of 2025. On 04/14/25, R1 exited from Memory care to the 1 st floor without any staff witnessing the elopement. On 04/28/25, W2 requested that R1 take a stroll with the Care Companion (1:1), action was denied by S1 and S5. S2 confirmed that R1 was unable to leave with the 1:1 because the staff were trying to get R1 acclimated to residing in Memory Care. Licensee does not ensure that medical staff are able to communicate with staff regarding residents in care. W1, and S5 stated that the fax machine was not working but was not able to confirm the fax number; W1 stated the date was around January 2025. LPA confirmed that the fax number 510-788-XXXX is not working per the notification on the fax cover sheet from the facility dated 04/2025. W1 was not able to confirm the correct fax number because the facility had not given W1 any advance notification. LPA confirmed that 510-705-XXXX is a working fax, and was last tested 01/28/25 per records reviewed. Continued on LIC9099C. ...continued from LIC9099C. Facility fax is in disrepair. W1, and S5 stated that the fax machine was not working but was able to confirm the fax number. LPA confirmed that the fax number 510-788-XXXX is not working per the notification on the fax cover sheet from the facility. W1 was not able to confirm the correct fax number because the facility had not given W1 any advance notification. LPA confirmed that 510-705-XXXX is a working fax and was tested on 01/28/25. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of corrections (POC) by plan of correction due dates and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted, appeal rights, and a copy of this report provided to Justin Zackzewski, Director of Hospitality.