complaint·September 30, 2022

...Continued from LIC 9099 LPA interviewed 4 staff. According to an interview with staff 1 (S1), all residents need some sort of assistance with ADLs and there are two residents on the lower level service side that require staff to feed them for all meals. S1 stated the facility has staff that are designated to feed the residents either in the dining hall or in their room. S1 stated staff also assist residents who need assistance with utensils. Staff will observe the residents for the duration of their meal time. The facility documents daily percentage of food intake on a sheet of paper, which is kept in the medication room. S1 does not know of any resident not being fed or hygiene not being attended to.  According to Staff 2 (S2), there are two additional residents on the higher level service side that require assistance with feeding. S2 stated one resident recently needed to have services added to their care plan due to concerns raised by their family. S2 stated after services were added to their "Quick Mar" system, services were implemented right away. S2 stated, "the only time a person is not fed is if they refused to eat." Staff are to ask residents multiple times, save the plate, and document how much they ate or refused. According to S3 and S4, there was never a time where a resident did not get fed unless they chose not to eat. LPA Valerio received photo documentation for resident 3 (R3). LPA reviewed 4 pictures from July 4th, 2022 and 5 pictures from July 14th, 2022. LPA observed R3 to have a thick layer of oral thrush on the inside of R3's mouth. The thrush was an opaque/white color that was on the surface of the tongue, in between teeth, and on inside of the cheek. According to mayoclinic.org, "oral thrush is a condition in which the fungus Candida albicans accumulates on the lining of your mouth." To prevent oral thrust, mayoclinic.org recommends to rinse one's mouth, brush teeth twice a daily, floss daily, etc. According to the pictures, R3 suffered neglect due to the facility not ensuring to assist resident with hygiene needs. According to the responsible party for R3, R3 cannot speak; however, can communicate by answering yes or no questions. The questions are asked and R3 will squeeze the hand. When R3 was asked about food and hygiene, R3 answered yes to not being helped for feeding and yes to no one brushing teeth. Based on records review and interviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8) are being cited on the attached LIC-9099D. Failure to correct the deficiency may result in civil penalties. Appeal rights were provided. An exit interview was conducted, and a copy of the report was provided to Administrator Julie Kramer.