complaint·September 15, 2023

Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (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. Appeal Rights and a copy of this report provided. Allegation: Staff yells at resident Investigation Finding: Unsubstantiated During investigation, Staff (ADM) denied yelling or hitting any resident at the facility. Residents (R1, R3, R4) confirmed with LPA that staff do not yell or scream at them. Residents state that staff treat them well and have no concerns residing at the facility. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation that staff yells at resident is unsubstantiated. Allegation: Staff overcharge resident on transportation and incontinent supplies Investigation Finding: Unsubstantiated During investigation, administrator (ADM) stated that responsible party (RP) arranges for residents (R1, R2) transportation to medical appointments and pays the driver directly. Review of R1 and R2’s admission agreements dated 10/27/21 show RP provides for transportation of residents to medical and dental appointments. LPA also reviewed signed admission agreements dated 10/27/21 which states that supplies required for incontinence shall be provided by the responsible person and will not be supplied by the facility. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation that staff overcharge residents on transportation and incontinent supplies is unsubstantiated. Allegation: Staff is not trained/certified to care for Alzheimer’s & Dementia residents Investigation Finding: Unsubstantiated During investigation, administrator (ADM) confirmed with LPA that staff has completed 10 hours of Dementia/Alzheimer training. LPA reviewed staff (S1, S2, S3, S4, S5) training certifications on Dementia/Alzheimer dated 06/20/22. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation that staff is not trained/certified to care for Alzheimer/Dementia residents is unsubstantiated. Continued on next page, LIC 9099-C pg2 Allegation: Financial abuse Investigation Finding: Unsubstantiated During investigation, LPA interviewed residents (R1, R3, R4) who state that staff do not financially abuse them. They pay their monthly dues based on the agreed upon admission agreements/addendums. LPA reviewed residents (R1, R2) admission agreements signed by responsible party (RP) dated 10/27/21, higher level of care monthly rate increase signed by RP dated 04/13/22 and notice of monthly charges increase signed by RP dated 06/01/23. LPA observed a comprehensive written description of the rate increase and payment procedures on all documents. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation that staff financially abuse residents is unsubstantiated. Allegation: Staff limits private visitation hours and social activity Investigation Finding: Unsubstantiated During investigation, administrator (ADM) denied limiting visitation hours and social activity for residents. ADM stated visitors are screened for COVID symptoms by staff to ensure they follow the infection control public health requirements and not compromise the health and safety of residents and staff. LPA interviewed residents (R1, R3, R4) who confirmed that family and friends visit them at the facility with no restrictions from staff on visitation hours and social activity. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation that staff limits private visitation hours and social activity is unsubstantiated.