complaint·July 15, 2025

Continued from LIC9099. During initial interview W2 stated that emergency services wasn’t called in a timely manner being S1 called R1’s responsible party first and was then instructed to call 9-1-1. W2 further stated R1 was found unconscious and there was not an attempt to resuscitate. S1 stated during interview that due to R1 expiring of natural causes the responsible party was contacted first. S1 stated she was at the facility but was not able to provide what other staff were present. Allegation: Facility staff did not provide consent documents to emergency providers. W1 stated during interview that R1 had a physician order for life-sustaining treatment (POLST). W1 stated a lady (unknown name) handed her papers. S1 stated the facility did not have any of R1’s documents and was unsure who took the documents from the facility. During record review of the physician orders for life-sustaining treatment (POLST) dated January 12, 2024, indicated to attempt to resuscitate. Allegation: Facility staff did not notate resident's medications that were taken. W1 and W2 stated the facility did not notate any of R1’s medications that were taken. Both feel some of the medications were missing, but it is unknown if R1 had taken the medications or someone at the facility. W2 stated documents were given to W1 and did not indicate that R1 had taken any medications during the time she was there. S1 stated the facility did not have any of R1’s documents. LPA reviewed the medication administration record that was dated May 1, 2025, to May 31, 2024, and there was not any date noted where the Continued on LIC9099C. Continued from LIC9099C. medication was taken. The Department reviewed pictures of medications that was submitted, however, was unable to determine if medication was taken by R1. W1 stated during interview that a staff gave documents and W1 gave a description of the staff. Allegation: Facility did not refund responsible party for the remainder balance for the month. S2 stated during interview that the facility did not refund the balance of the month’s rent. S1 stated that she had an agreement with R1 that there will not be any refund for the 1 st month. Health and Safety Regulation 1569.652© states: “A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed.” Based on interviews which were conducted and record reviews, 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. Exit interview conducted. A copy of the appeal rights and this report provided. Continued from LIC9099. were in a drawer in the bedroom and some medications were in a gray bag in the closet. S1 stated that R1’s medication was no accessible to R1 during her admission, but all R1’s belongings were in the room for her responsible party. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED . Exit interview conducted and a copy of this report provided.